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Cbe Librarp
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JOSEPH RUZICKA
BOOxetMOERS
BALTIMORE.MO
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JUL 1 5 ]%]
LUNC-15M N.36
OP-13370
Putlislyed h^ TAZ. N°KJI\ (M9Lm^ 5TATL D°ARD s^AE^LTA
This BulkliAwillbe -serxt free to qu\3 ci"tizer\ of Ihe State upor\ request.!
Entered as second-class matter at postoffice at Raleigh, N. C, under Act of July 16,
1S94. Published monthly at the office of the Secretary of the Board, Raleigh N. C.
VOL. XLV JANUARY, 1930 NO. 1
The midwife class of Person County. These women have been taking a
course of instruction provided by the county health department, spo7isored by
Miss Ruth McCollum, the county nurse. It is a creditable looking group. They
are putting into effect the practical idea of improving the status of all mid-wives
as long as there remains a single woman needing their services.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OP HEALTH
A. J. CROWELL, CTRUS M.D., President r>>,o^i^«.» THOMPSON, M.D._ tV.v^ ^m* THOMAS E. ANDERSON, M-DTI: «^t^f°°yH '
E. J. TUCKER, D.D.S._. I
Statesville
D. A. STANTON, M.D._r___ ' £rV u ?. •
°
JAMES P. STOWE, Ph.G. ^^Mu ^^i?* JOHN B. WRIGHT, M.D Charlotte
L. E. McDANIEL, M.D. __ Raleigh
CHARLES C. ORR, M.D. 1- i"^t*^^?," Asneville
EXECUTIVE STAFF
ROnIld^ ^V^olEf^a^^^.^^; }^-^i:
KONALDB. WILSON Secretary and State Health Officer. Assistant to the Secretary.
?< V; ^M93^ M.D., Director State Laboratory of Hyeiene
H E- M?TI'^' ^^' ?i5*?'°^ g^^^*^ «' Health Educatfon.
F m" REmf^R Mh^^A^^ "t
Bureau of Engineering and Inspection.
H A TAVTHT?^^ •i*-°/'^^^^°?'.B".^^,^^ °^ V"^l Statistics. t±. A. iAYLOR, M.D., State Epidemiologist.
^^g^Qf COLLINS M.D Director Bureau of Maternity and Infancy.
iErR;>NTfEvS^^TriSK, M.D., Director of County Health Work A. BRANCH, D.D.S., Director of Oral Hygiene.
FREE HEALTH LITERATURE
whi-Jw^-lfhl^ ^^^'^ of Health publishes monthly The Health Bulletin,
T^LSkT l^i-^r^-^""!? *° ^"7 "^'^^^ requesting it. The Board also has available for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested
Adenoids and Tonsils
Cancer
Catarrh
Care of the Baby
Constipation
Colds
Clean-up Placards
Chickenpox
Diphtheria
Don't Spit Placards
Eyes
Plies
Fly Placards
German Measles
Hookworm Disease
Infantile Paralysis
Indigestion
. Influenza
Malaria
Measles
Pellagra
Public Health Laws
Prenatal Care
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placards
Typhoid Fever
Typhoid Placards
Veneral Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY AND INFANCY
.pnt'^f!^!/t"'''^'"^-'.?^"^^^'tf^i"'"^ °" ^^^ subjects listed below will be
Health, RaleighfNlc.?
^^^^ °'' ''^"''* *° ^^" ^^^^^ ^°^^d °f
Prenatal Care (by Mrs. Max West)
Infant Care (by Mrs. Max West)
Prenatal Letters (series of nine
monthly letters)
Minimum Standards of Prenatal Care What Builds Babies?
Breast Feeding
Sunlight for Babies
Save Your Baby
Hints to North Carolina Mothers Who Want Better Babies
Table of Heights and Welgiits
The Runabouts in the House of Health
(pamphlet for children from 2 to 6 years of age)
Baby's daily Time Cards: Under 5 months; 5 to 6 months; 7, 8, and 9 months. 10, 11, and 12 months; 1 year to 19 months; 19 months to 2
years.
Diet Lists: 9 to 12 months; 12 to IS months; 15 to 24 months; 2 to 3
years; 3 to 6 years.
CONTENTS
PAGE
North Carolina Health Prospects
For 1930 ^^____ 3
Practical Health Teaching' In Wilk-inson
School 4
Recalls Days of Embalmed Beef and
Typhoid Fever 6 Vitamin Band Pellagra 7 Preventing Unnecessary Noises—1__ 8 Heart Disease and the Public Health 9 Who Is Educated? 10 Practice of Medicine Regarded as
Public Utility 11
PAGE
Driving On Left Side of Road 13 Broken Wings 14
Vaccination Pacts 21
College Blues 23 Our Lives Shorter, Not Longer 25
Common Sense and the Open Win-dow^
26
Dosers 28
Our Back Cover Cartoon 29 How Very Few of Us Die 30 An Encouragement 31
VOL. XLV JANUARY, 1930 NO. 1
NORTH CAROLINA HEALTH PROSPECTUS FOR 1930
Facing a new year is an adventure
for everj" living human being from the
infant in its crib to the individual
who has marked off three score and
ten years. For many of the infants,
too many of them, the journey will
be perilous. For many of the aged it
will mean embarkation on the "Third
Puzzle" of human existence. Accidents
and untimely deaths, most of which
are preventable, will take heavy toll
among the intervening ages. The same
history is recorded year after year.
It is the business of a health depart-ment
to make the traveling of the in-fants
less hazardous, to reduce the
preventable toll taken from those of
active age, and to defer the em-barkation
of those of advanced years
as long as possible.
The practical question is, how may
these things be done? The equally
practical answer is, by efficiencj',
honesty and industry on the part of
health department personnel, county,
city, and state, in vigorously teaching
the people how to apply the scientific
principles of disease and accident pre-vention.
We herewith set forth some of the
things that might be done.
Every prospective bride and groom
might be taught the dangers of ve-nereal
disease with the disastrous
consequences which so often follow
such infection. Every prospective
mother should receive expert care and
adx-ice during the entire pre-natal
period. She should have the proper
kind of food in adequate quantity. Any
abnormal condition manifesting itself
should have immediate medical at-tention.
During the birth process ev-ery
needful attention should be avail-able.
Thus the maternal dangers may
be largely eliminated. The infant then,
given a healthy heritage free from
venereal infection, may have at least
an even start. Every infant born
should have right from its first hour
the inalienable right of nourishment
from its mother's breast, unless a com-petent
physician certifies that breast
feeding would be dangerous for the
mother and disastrous for the infant.
Soap is cheap and water, fresh air and
sunlight in North Carolina is practic-ally
unlimited the year round. The
baby should, therefore, have a clean
bed, regardless of rags or poverty
(the rags can be clean ones), mother's
milk, sunlight and clean air. The male
relative with pipe or cigar, or the
mother with cigarette, should be equal-ly
barred from the baby's presence as
the visitor with a cold. Give the baby
air free from the germs of respira-tory
infection, the irritating effects of
nicotine loaded smoke, good breast
milk, a clean bed, good heritage from
healthy parents, let it alone and the
chances are better than even the baby
will do the rest for the first eight or
nine months of life. Careful attention
to the establishment of health habits
with assurance of right kind of food,
frequent inspection by the family phy-sician
and dentist will take care of the
pre-school period and ensure the pre-sentation
of a healthy young animal to
the school at the ripe and experienced
age of six. These first six years are
the important ones. Then is the pe-riod
when the parents should know
The Health Bulletin January, 1930
the water is pure, the milk safe and
the food of the right kind, adequate
and properly prepared. Two of the
most important things to do during
the first year is to see that the infant
is successfully vaccinated against
smallpox and that it has three ade-quate
doses of a fresh product of
toxin-antitoxin properly administered
to guarantee against diphtheria.
Measles, whooping cough, and scarlet
fever should be guarded against with
all possible care. Six years old and
healthy when school troubles begin
means power to win if the teacher is
intelligent. There are so many aids to
good health now available for the
school children almost all over the
State, that no pupil's health should be
jeopardized during these years. Never-theless
many thousands of them have
their health seriously impaired in
many ways which could be avoided.
But we may take heart here for the
teachers are learning. It is the solemn
duty of every health officer to help
teach them, and none the less the ob-ligation
of every practicing physician
to do the same thing. Shorter school
hours for younger children, all those
under twelve, and rigid supervision of
school cafeterias may be regarded as
the two most imperative demands for
better health safeguards for school
children. It ought not to be necessary
to say that if any child is so unfor-tunate
as to be admitted to school this
year before receiving a successful vac-cination
against smallpox and diph-theria
this important deficiency should
be remedied during the first thirty
days of school.
In all the foregoing the one respon-sible
individual who is paid a salary
from public moneys to do these things
is the local health officer. It makes no
difference whether he is a full time
official or a part time one, the obliga-tion
is equally binding. It is no use
to say the fault is the parents, or the
practicing physician's when failure to
invoke protection is present. The
health officer must secure the coopera-tion
of parent and family physician.
Details and methods by which things
may be done are unimportant. Getting
them done is the important point.
Plans and programs should be made
to fit the local needs. But the prin-ciples
are fundamental and State-wide.
For the general population atten-tion
should be given to a more plenti-ful
supply of fruits and vegetables
and an increase in the consumption of
dairy products, poultry, eggs, meat,
and fish, by people who need to guard
against the deficiency diseases. Pure
water, whether it be for village or city
dweller or on the farms, should be
made available. Better safeguards to
assure clean and safe milk. Adequate
screening of all houses, the extension
of sewage facilities and sanitary
privies where needed are among some
of the things to be looked after in our
1930 health prospectus.
More humane and sympathetic care
for the aged and the "down and out;"
the better safeguarding of the health
of working people in all kinds of in-dustry
and agriculture are among our
biggest needs. For the adult individual
a health examination, a really truly
health examination, not a pulse feeling
and tongue inspecting enterprise,
would if included in the year's pro-gram
add much to the happiness of
all such wise folk as well as possibly
adding a little something to the span
of life.
May your New Year be what you
try to make it.
PRACTICAL HEALTH TEACHING IN THE
WILKINSON SCHOOL OF ROCKY MOUNT
Early in October the teachers of the
Wilkinson school of Rocky Mount,
North Carolina, wrote to the State
Board of Health explaining a plan
they had for the practical teaching
of health matters in the school this
January, 1930 The Health Bulletin
year. They informed us that they had
about three hundred and twenty-five
pupils in this particular school.
The plan that they proposed to put
into effect is one that any wide-awake
school of the State can also utilize.
Briefly speaking, they propose to take
up one phase of health teaching each
month and study that exhaustively.
They selected as their subject for the
month of October the care of the teeth.
They asked us to supply them with
literature in the form of a short
pamphlet on the care of the teeth,
sufficient to supply each one of the
pupils with a copy. It so happened
that we have been distributing for ten
years all throughout North Carolina a
carefully written special pamphlet on
the care of the teeth. This little
pamphlet has two cuts, one a drawing
of the temporary teeth and one that
of the permanent teeth. The two are
placed on the same page. Each tooth
of each set has the proper name and
the approximate date of eruption.
The teachers of the Rocky Mount
school proceeded to examine each child,
writing his or her name on the pam-phlet
to begin with. Whenever they
found a child who had a particular
tooth corresponding to the tooth on
the plate, either temporary or perman-ent,
which was decayed, they mark-ed
this particular tooth "decayed" or
"needed dental attention." Each child
was then asked to take this pamphlet
home and to show the parents the sit-uation
that the teacher had found.
This is certainly beginning at the
beginning and is one of the most ef-fective
methods of teaching practical
care of the teeth we have ever seen.
The method assures concentrated in-terest
on the part of the parent at a
time when it will probably do more
good than it could ever do again. The
information carried in the pamphlet
is sufficient to explain to the parent
the importance of taking action imme-diately.
No dentist in the world could
criticise this procedure. The examina-tion
was not a dental examination, and
if a tooth had a decay in it big enough
for a teacher to see, it is a self-evident
proposition that the dental services
were needed; and, after all, the re-sponsibility
of health departments and
teachers is to get children who need
dental or medical care into the hands
of capable dentists and physicians.
This procedure on the part of the
Rocky Mount teachers strikes us as
being the finest method yet devised
to do that particular thing.
To go a little farther along with
the Rocky Mount program, another
month, after they settle the teeth
question, is to be devoted to the ques-tion
of a study of the prevalence, dan-gers,
and prevention of diphtheria.
Here again we are able to provide
them with literature which is to the
point, sufficient for each child and its
parents to have. In this way every
parent who is patronizing the Wilkin-son
school in Rocky Mount will have
directly called to his attention the fact
that diphtheria may be easily pre-vented
through the administration of
toxin-antitoxin to any young children
in their families. If the parents do
their part and act on the suggestions
which will be brought directly to them,
there should not be a single case of
diphtheria developing m the Wilkinson
school of Rocky Mount when the fall
session of 1930 opens. This will give
ample time for the immunization
thi'ough the winter and spring of any
children in homes patronizing that
school for the immunization to take
full effect before the school opens next
September.
And another item of vast import-ance
to the health of the school chil-dren
is the question of foods. The
teachers propose to take one month for
the study of the particular kind of
food, the quantities, and so on that
school children should have. These are
only items illustrative of the fine and
comprehensive program these teachers
are carrying through.
We take pleasure in departing from
our usual custom in which we are
The Health Bulletin January, 1930
treating all matters these days dis-cussed
in the Bulletin in an imperson-al
manner, by mentioning the names
of the two teachers who have initiat-ed
this program. Communication to
the State Board of Health was made
by Miss Charlie Westbrook, one of the
teachers in the Wilkinson school, and
Miss Bessie McDearman, principal of
that school. We hope that other teach-ers,
when engaged in their schools, will
follow the example of these wide-awake
teachers in this particular
Rocky Mount school. The field is un-limited
and the need is great for just
such practical teaching.
RECALLS THE DAYS OF EMBALMED BEEF AND
TYPHOID FEVER
Thirty-two years ago this month the
battleship Maine was blown up in Ha-vanna
Harbor, and very soon there-after
the country was at war with
Spain. Some few weeks ago the Mon-roe
Journal published a rather poig-nant
little story from a Monroe citi-zen
who is a veteran of that war. The
story recalls to mind so graphically
the conditions in this country, and in
the army where typhoid fever killed
many more soldiers than Spanish bul-lets,
that we herewith publish it in
full. To a present-day health officer
in North Carolina it will read like a
story from some ancient and musty
history. However, there are many of
us who can remember only too well
the conditions that existed in the civil-ian
population in North Carolina just
as well as obtained in the army.
This man speaks from personal
knowledge. He was a victim. The story
has gone the round many times of a
pompous major general of one of the
camps walking up and tearing from
a polluted well a notice from the med-ical
department warning the soldiers
not to drink the water from that par-ticular
well. This old incarnation of
political authority, and ignorant of
things outside of his particular tech-nical
training, proceeded to drink of
the water and to remark that all this
medical palaver was foolishness. At
the time hundreds of his soldiers were
sick from typhoid fever, and many of
them were dying every day. We have
certainly traveled some distance since
that day. Read the story that this sol-dier
tells, and take heart that in some
things the world is not as bad as it
was thirty-two years ago.
"When Mr. John Holloway put on
his uniform of a soldier of the Span-ish-
American War, people said, "Hel-lo,
Mr. Holloway, I didn't know you
were a Boy Scout.'
"That riled John, riled him to think
that the war in which he had been a
soldier and came very near losing his
life, could be totally forgotten by the
older people and wholly unknown to
the young.
"But that is about the truth of it.
And the government takes the same
attitude, says Mr. Holloway. It does
just about half as much for a veteran
of the Spanish-American War as it
does for one of the World War for
exactly the same disability. And
though it paid him only fifteen dollars
and sixty cents for soldiering, it mus-tered
him out without any compensa-tion
adjustment at all.
"Dewey captured the Spanish fleet
in Manila bay on May first, 1898, and
Schley smacked the Cevera fleet on
July fourth. At that time the Ameri-can
soldiers, every last one of them
volunteers, were being prepared to
land in Cuba, but a lot of them never
got there. They were already dead or
dying of typhoid fever or starving on
embalmed beef in the concentration
camps. John Holloway was one who
was laid up with typhoid fever and his
leg was swollen as big as his body
when his regiment embarked for Cuba.
"There are a good many more Span-ish-
American War veterans around
here and there and no doubt they feel
January, 1930 The Health Bulletin
about like John of the hardships of
that war and the scant attention they
now receive, especially as John says,
since what they underwent caused the
revolution that swept away the men-ace
of embalmed beef, cheating con-tractors
and such like and started the
war against typhoid and made army
camps at last free from such dis-eases."
VITAMIN B AND PELLAGRA
In a letter to the Editor of the Bul-letin
sometime ago a physician friend
remarked that he could not see why
pellagra should be regarded as a de-ficiency
disease in view of the fact that
the pellagra preventing principle in
food known as vitamin B is the most
widely disti'ibuted vitamin in nature,
and so that practically the diet served
on all tables in the homes of the peo-ple
of this State therefore had an
abundance of vitamin B, and that they
could not help eating a considerable
amount of food containing this vita-min.
The fact that vitamin B is present
in the leafy vegetables such as let-tuce,
cabbage, spinach, turnips, in liv-er,
kidneys, tomatoes, beans, peas, po-tatoes,
eggs, milk, in addition to the
large amount found in yeast and the
basic foods of every family, cereals,
would seem to afford a sufficiency of
this necessary element. It is, of course,
true that an abundance of this vitamin
is available, provided we eat it.
We have just called cereals the basic
food of every family. This is true, be-cause,
in North Carolina at least, corn
bread, white store bread, or biscuit
made from white flour, composes the
bread diet for ninety-nine per cent or
more of the people. In a thorough-go-ing
study of this point the late Dr.
Edward J. Wood made a special trip
to some of the large flour mills in the
Central West in order to see the pro-cess
employed in making flour, a large
quantity of which was shipped and is
shipped to this State for consump-tion.
He made the same investigation
concerning the manufacture of the
commercial corn meal handled in large
quantities by the grocery stores of this
section also. He learned that the germ
of the wheat, and of the corn, was
removed in the milling process, be-cause
this portion of the grain, which
contains the vitamin B, if retained,
then the flour or the corn meal was
many times more subject to mold and
spoilation in shipping, and therefore to
commercial loss.
People who eat the native whole
wheat bread from wheat made in this
section, or at least milled in this sec-tion,
and which contains all of the
This little Youngaville girl weighed
only two pounds when one ivcck old.
She lay on a pillotv in a bassinet with
hot water bottles around her for the
first three months. During this time
she teas fed lactic acid milk sweetened
ivith corn syrup, and administered
with a medicine dropper. She is a fine
example of what may be done with
patient and intelligent care, includ-ing
parental, nurse and medical.
8 The Health Bulletin January, 1930
wheat kei-nel, including the germ, get
the vitamin B in proper proportion.
In the same way the many thousand
families in the State who embrace the
opportunity of getting their corn meal,
from which they make their corn
bread, from local grist mills, especial-ly
from local mills in which the North
Carolina corn is utilized fresh from
the barns and fields of the local farm-ers,
also get vitamin B in their corn
bread, although in smaller proportions
than in the whole wheat bread. Dr.
Wood therefore held that the basic
cause which made pellagra possible
was that the people who had been de-pending
upon a diet rich in the gei-ms
of wheat and corn in their bread,
when deprived of this through the
commercial products utilized in recent
years, failed to get enough of the pel-lagra
preventing principles by eating
it in other foods, sufficient to make
up for the deficiency.
We reiterate here the doctrine of
Goldberger and Wood, that it is not
only necessary to have an adequate
diet on the table containing an abund-ance
of vitamin B, called by Goldberg-er
the pellagra preventing principle,
but it is essential that this diet be
consumed by the person who would
avoid pellagra or other deficiency dis-eases
of like character.
PREVENTING UNNECESSARY NOISES
Some of the health departments in
the various cities of the country are
very much concerned over the ques-tion
of control of unnecessary noise.
The city of London has had various
commissions at work making surveys
in their thorough-going style as a pre-liminary
to city ordinances drastical-ly
extending control in order to pre-vent
these nuisances. In this State the
city of Greensboro raises a big fuss
about the blowing of train whistles
and the exhaust racket kept up dur-ing
the night by a surplus of motor
cycles. In some of the cities of the
North street cars are blamed for a
great deal of the noise, the city of
Dayton, Ohio, in its Health Bulletin
declaring that there had been no im-provement
from a noise standpoint in
the operation of street cars of that
city in a third of a century.
Nearly all the cities and towns in
our State find the unnecessary blow-ing
of automobile horns nothing short
of an unmitigated nuisance. The vi-bration
caused by heavily loaded
trucks running at rapid speed on the
streets at all hours of the night is
another cause for complaint. For the
most part the latter are engaged in
the work necessary to be done for the
welfare of the people, and nothing we
know could be done to prevent it ex-cept
better training of the drivers as
to how to reduce the racket to a min- I
imum. In the case of blowing automo-bile
horns, in our opinion about one
toot every six months for the average
car is sufficient. The fact is that the
manufacturers ought to be prohibited
by law from equipping cars with
horns. If this nuisance were drastical-ly
abated in the foregoing manner,
and an ordinance strictly enforced, re-quiring
all drivers to keep well to the
right side of the road, there would not
be any possible excuse for a horn on
an automobile. Some critic might prob-ably
say that it would still be neces-sary
to warn pedestrians, but the fact
is that a few sharp blasts from the
automobile horn when a pedestrian is
crossing the street only tends to con-fuse
him and make bad matters worse.
The pedestrian, of course, must be
taught to look before he crosses the
street, just as the automobile driver
should be trained to stay on his side
of the road. The ringing of the train
bells and the blowing of locomotive
whistles day and night in thickly
populated resident portions of town
certainly should be reduced in volume
|
and used only as a necessity in the
safe operation of trains. For the rath-
January, 1930 The Health Bulletin
er large volume of sound as an inci-dent
of making general "whoopee" in
the residential sections of towns in all
hours of the night, that is a matter
for education and regulation by com-petent
authorities.
HEART DISEASE AND THE PUBLIC HEALTH
It was not until about the beginning
of the present century that tubercu-losis
was definitely recognized as a
public health responsibility. Only re-cently
cancer has been placed in the
category of diseases constituting a
public health problem. The fact is that
it is not even so recognized every-where
now. The extremely communic-able
diseases like smallpox have natur-ally
been looked upon as public health
problems all the time. We are glad to
he able to record the fact that now
heart disease is coming to be looked
upon as just as definitely a public
health problem as cancer is.
Progress tov/ard the control of the
spread of tuberculosis is much more
satisfactory now that it is realized
that the disease is almost always con-tracted
in childhood through exposure
of infants and very small children to
contamination with the fresh sputum
and other discharges coming from tu-berculous
patients living in close con-tact
with the infants. When it was
learned that this infection was pres-ent
in latent form in the children, to
become manifest in later years, then
it was that the most intelligent efforts
could be directed against the eradica-tion
of the disease.
It is now realized that about seven-ty-
five per cent of all cases of heart
disease develop in children ten years
of age or under, and that only about
ten or twelve per cent develop in per-sons
over forty years of age. Heart
disease is one of the gi-eat killers of
this country. More than twice as many
people die each year from heart dis-ease
as do from kidney disease or from
cancer or from pneumonia; and these
four diseases constitute the four chief
causes of death.
Another disturbing element is that
the rate of death from heart disease
is increasing about twice as rapidly as
the rate of population increase. Often
heart disease is congenital; that is, a
child is born with the disease present,
and in such cases nothing can be done
to prevent its development and the
probable early death of the child. The
only thing in such possible cases that
can be done is to pay more practical
attention to the care necessary to safe-guard
expectant mothers. The other
form of heart disease; that is, the
form that is acquired after the healthy
birth of a baby, is nearly always due
to complications resulting from com-municable
disease, or to improper hab-its
of living.
The group of diseases known under
the general term as rheumatism is
notably large. Rheumatism is at this
time believed to be a germ disease.
For many years the doctors and den-tists
have had a great deal to say
about focal infections. In these condi-tions
so-called rheumatism infection
is frequently a result of diseased ton-sils
or decayed teeth, the germ gain-ing
entrance into the blood stream
through such conditions in the body.
The chief thing to emphasize in this
connection is that the best method of
prevention of such conditions is to pre-vent,
when possible, decayed teeth,
and also to preserve, if possible, norm-al
tonsils, through care for the gen-eral
health of the child before and
after birth, the prenatal care, of
course, directed to proper hygienic
living, proper food, and the freedom
from disease of the mother.
The United States Public Health
Service in a recent publication stated
the tabulations of physical records of
five thousand school children under
their supervision showed that of the
children whose tonsils had been remov-ed
for serious tonsillar infection in
10 The Health Bulletin January, 19SO
A fine pair of Jackson County twins.
At present both are underweight, but
we hope that handicap will be re-moved
at an early date.
the past, twenty out of every hundred
had attacks of rheumatism, and of
the children with defective tonsils
which had not been removed, seven-teen
out of every hundred had rheum-atism.
With the former group, four
had heart disease, and of the latter
group, three out of each hundred had
heart disease. The showing, however,
for children who had normal tonsils
which had not been removed and
which were not diseased was much
better, not more than one-third as
many having indications of heart dis-ease.
The use of the word "rheumatism"
is somewhat misleading, because of
the fact that in the past so many
poorly classified conditions have been
diagnosed as rheumatism. This has
been done to the point where the
average intelligent physician feels
that when the word "rheumatism" is
used, it is done so as a general term,
and means very nearly nothing. Much
experimental research work remains
to be done in this group of diseases
before an intelligent classification can
be made. It is sufficient for our needs
in this discussion, however, to recog-nize
the fact that heart disease is an
increasing menace, and that it results
from many communicable diseases as
well as from improper habits of liv-ing.
In conclusion, we would like to em-phasize
again the fact that to do any-thing
much with heart disease requires
an early beginning, and it is one con-dition
in which prevention is about
the only logical procedure toward
which all efforts at eradication should
be directed.
WHO IS EDUCATED?
September and October this year
have been disappointing to the State
Board of Health officials and to the
public health workers in general in
North Carolina because of the fact
that the presence of diphtheria, judg-ing
from cases reported throughout
the State, has been just as serious, if
not more so, than in previous years.
We have said it several times be-fore
orally and in print that there is
today in North Carolina no excuse for
a parent whose child has diphtheria.
The reason for this statement is that
toxin-anti-toxin properly administered
to young children affords such a max-imum
of protection that it is exceed-ingly
rare for any child to have diph-theria
after immunity is secured
through the administration of toxin
antitoxin.
A short time ago a close personal
friend of the writer, a university grad-uate
and an important North Carolina
educator, was detained at his home on
account of an attack of diphtheria in
his youngest child, a boy of six years
of age. The child had started to school
at the opening of schools in Septem-ber.
Naturally being exposed, as so
many other thousands of children are
every fall, for the first time to diph-
p
January, 1930 The Health Bulletin 11
theria and other contagious diseases,
not having had the protection afforded
by toxin-antitoxin, and being suscep-tible
to the disease, he promptly con-tracted
diphtheria. The wife of this
friend is an educated woman. Both of
them have had access to the litera-ture
and other channels of informa-tion
concerning every protective de-vice
available for the rearing of their
children. Their home is located within
four blocks of one of the four oldest
whole-time health departments in
North Carolina. The health officer in
that county has been giving toxin-antitoxin
at frequent intervals to the
children of all parents who would take
the trouble to bring them to the office
or arrange the schedule in the differ-ent
sections of that particular county.
The same thing has been done in many
other counties, and yet there are lit-erally
thousands on thousands of chil-dren
in North Carolina today who
have not been given this protection by
their parents. Our friends in response
to the question as to why they had
neglected to protect their child
through toxin-antitoxin last spring
and summer, knowing that their child
would start to school this fall and be
exposed to diphtheria, replied that
they just simply had not done it. They
were not indifferent to the value. They
were not in ignorance of its protection,
but they simply had not got around to
it.
A few days later we were in the of-fice
of the health officer of Randolph
County just preceeding a county-wide
teachers' meeting in which the super-intendent
of Randolph County schools
was making a particular point to em-phasize
the importance of public
health protection at his very first
county-wide teachers meeting held in
the county. While we were sitting in
the office conversing with the health
officer, a nearby farmer came in with
his two children, a little boy of four
and a baby of fifteen months. They
had been there for their first dose a
week previous, and on entering the
office the little four year old began
pulling up his sleeve, and, with a
broad grin on his face, told the health
officer he was "ready for another one."
In less than a half minute the health
officer had administered the second
dose of toxin-antitoxin to the fine little
chap. There was just about as much
pain as a mosquito bite, and if the
reaction is no worse than the average,
that was the last that the little fel-low
would hear from that dose.
Now our question is, so far as pub-lic
health protection goes. Whose edu-cation
in these cases proved to be the
most practical?
PRACTICE OF MEDICINE NOW REGARDED AS A
PUBLIC UTILITY
Doctor Henry G. Longworthy is the
treasurer of an organization known
as the Inter- State Post Graduate Med-ical
Association of North America. He
wrote an article which was published
in the September issue of the Nation's
Business Magazine. He begins his ar-ticle
with the astounding statement
that "The practice of medicine today
may be regarded as a vital public util-ity
function well regulated by law and
well managed by physicians, hospit-als
and social agencies."
He pictures the physician of the
present day who practices medicine in
the city as a "bedside medical engi-neer."
He says that as a medical ex-ecutive
such a physician "engineers or
calls to his aid at the bedside for the
benefit of the patient, all necessary
consultations, hospital facilities, nurs-ing,
diet, and all the other sciences.
In many cases for the diagnosis and
treatment of a single patient, this
medical executive will use the services,
directly or indirectly, of a dozen to a
hundred persons."
The foregoing is true and it is what
12 The Health Bulletin January, 1930
is making the practice of medicine to-day
one of the most complicated and
costly of professions. It accounts for
the enormous cost of hospital care.
The sinister phase of it is that the
successful physician can no more hope
or expect to get back to old style
economic individualistic methods than
he can expect or desire to return to
his saddle bags and home-made pills.
The danger in the situation lies in the
possibility of the physician (medical
engineer) becoming of necessity a sim-ple
cog in a vast machine whose final
superior may be a political cabinet of-ficer.
That is the spectre of State
Medicine so many thoughtful physic-ians
fear. In such an arrangement the
individual patient would receive about
as much personal and individual at-tention
as one biddie in an incubator
flock of ten thousand.
This is the day of big business. All
of us think and talk in terms of bil-lions,
whether it be debts or folks.
Mergers and combines are in complete
and glorious control of everything. The
pendulum has simply followed the
law of averages and swung back from
the period of thirty years ago when
no corporation or combine was too
small or too poor to be kicked. What
more natural then, in the present
mental state, than to regard the doc-tor
along with the chain store opera-tor
as a purveyor of a public utility
because he has something to sell that
most people have to have at one time
or another.
The writer in the aforementioned
article quotes Homer Folks in a state-ment
that the families of this country
having illness in the course of a year
pay out in actual cash on account of
such illness the astounding total of
two billion dollars. The same total
amount is spent annually for public
education—from kindergarten to post
graduate universities. If cost in loss
of time and other economic loss is in-cluded,
sickness costs the American
people every year about fifteen billion
dollars. So, we see that in a way the
practice of medicine and the conduct
of hospitals for sick people constitute
about the biggest public enterprise in
the country. That being true it is in-evitable
that business and medicine
should form a new alliance, and the
foundation stone of the enterprise
must be preventive medicine. The pre-vention
of disease is a public enter-prise.
To achieve its finest results it
must be organized like an army, and
in the struggle for the ideal of longer
life and sounder health, the army must
be composed of individual physicians.
No faculty ever educated a student.
What the student gets is the sum total
of efforts made in his behalf by indi-vidual
instructors. No medical society
ever cured a patient. Some individual
member of the group must assume full
responsibility and do the job if the pa-tient
is to benefit. And that is what
Dr. Longworthy meant by calling the
physician a bedside engineer. If the
mass of the people are to receive the
benefits of this new alliance between
business and medicine they that are
well must be told how they may keep
well. That is an individual problem.
Each must read what some one per-son
writes for him or he must be told
by some individual. Who is better
qualified than the physician? If the
person who is sick is to benefit he
must have the attention of an individ-ual
physician. In the final analysis the
things that must be done to reach the
ideal may be summed up about as fol-lows:
1. Knowledge concerning the cause
of disease and the prevention of its
spread must be placed in the hands of
every intelligent individual. This is a
purely public health responsibility.
2. The services of a competent phy-sician
must be available for every sick
person regardless of where he lives or
how poor he is, for so long a period as
he needs such service. TTiis is ob-viously
impossible at present. So
the business part of this alliance be-tween
medicine and business must
see that:
January, 1930 The Health Bulletin 13
3. Hospital facilities are placed
within the reach of all. The physician
must practice more and more in con-nection
with hospital and medical cen-ters.
These hospitals must be placed
in the rural sections as well as larger
towns. Under this arrangement the
physicians will have available all mod-ern
methods of aid in diagnosis. Such
a system will result in
4. Better care for the patient at
much lower cost than at present. A
physician will be able to treat many
more patients, and to treat them
more competently. Having his office
and home in such a center, even
though it be in a small town, the of-fice
or ambulatory patients may re-ceive
assurance of more satisfactory
care, and patients needing bed care
can receive it easily. The cost must
be many times less than at present,
and the physician must receive much
better compensation than he does
now. Business methods can assure all
this and the physician and patient will
both retain forever the fine individual
relationship that has obtained in the
past, surely to the vast benefit of the
patient.
DRIVING ON THE LEFT SIDE OF THE ROAD
Here we are again talking about
traffic on the highways. However, in
view of the fact that mortality due
directly and indirectly to automobile
accidents constitutes one of the major
causes of preventable deaths in this
State, we feel justified in continually
writing something in the Bulletin
about the matter. It has been neces-sary
in the progress of the science
of public health in driving away at
the preventable causes of death to
keep continually before the public
these particular causes and how a dif-ferent
public attitude might result in
preventing death from unnecessary
causes.
There are not many rules for safety
on the public highways, but the few
rules that there are constitute some
very important ones, the breach of
which causes many deaths and much
suffering among the people who are
the victims. With the thousands of
automobiles running along our main
public highways every day at high
speed, the least variation from the
known methods of safety may at any
time instantly result in death to one
or more persons.
It has been our observation in our
journeys to and fro around over the
highways that a frequent cause of
traffic trouble, accidents and death, is
the man who persists in driving along
on the left side of the road. There
seems to be a large percentage of
such pests exercising the privilege of
driving automobiles all the time. This
particular insect seems to delight in
getting on a crowded highway and
piddling along at a low rate of speed
on the extreme left-hand side of the
highways in the country, and in the
city or town he gets just as far over
the middle of the driveway to the left
as he can possibly get without having
a collision with cars coming from the
opposite direction. TTiey seem to think
that the roadway is better on that
side, or that the atmosphere is more
rarefied and purer, or they may do it
for just pure carelessness. The driver
who wishes to pass, even on an open
road, has to wear his horn out calling
attention to his desires before any
notice is taken. By the time he reluc-tantly
and slowly begins to turn in,
one or more cars heave in sight com-ing
from the opposite direction, which
makes it impossible to pass, often for
a mile or more.
The chief characteristic of the left
side of the road driver seems to be his
desire to drive along slowly. When
coming meeting such a driver the le-gitimate,
careful driver of an on-com-ing
car almost has his hair standing
on end before this pest seems to take
notice and grudgingly turns back to-
14 The Health Bulletin January, 1930
ward the right, perhaps getting out
of the line of traffic just about the
time the driver meeting him has to
slam on his brakes or leave the road-way
entirely to avoid hitting him. Such
a habit is dangerous for several rea-sons.
One of the chief dangers, of
course, is the impossibility of drivers
of cars behind him being able to see
an on-coming car, perhaps just be-fore
a road intersection, or, in their
efforts to pass him, the on-coming
car is obstructed from view, and ac-cidents
often result. Another thing,
it is bad for the nervous system and
therefore the safety of every driver
of a car, and to the people he meets,
to have his calmness or his equanimity
upset from any cause. Such driving
frequently results in fatal accidents
to pedestrians also.
After all, the question of driving
comes back to the very old one of good
manners. A polite, considerate, well-bred
driver of an automobile will think
of the convenience and safety of the
drivers of other cars, as well as his
own, and will therefore govern himself
accordingly.
We would suggest to all persons
reading these lines, who are accus-tomed
to driving an automobile that
they ask themselves the question: "Am
I a left-hand side of the road driver ?
"
If the answer is in the affirmative,
our advice and request is to quit it.
BROKEN WINGS
By
SuDiE E. Pyatt
Paul was falling from a couple of
thousand feet above the earth. His
plane had gone bad, the left wing was
broken. He was crashing toward the
earth at terrific speed with no time
to adjust his parachute.
Just before he reached the earth
that rose to meet his broke plane,
he awoke swearing.
"D—n!" He could hardly breathe.
That left lung, the one the doctor had
pumped gas into that day was pain-ing
him as if a sharp knife had been
driven through it. Pleurisy, and the
spot still sore from the passage of the
needle that had introduced the first
shot of air into the pleural space be-tween
his lungs and his ribs, caused
the pain. No wonder he had dreamed
he was crashing to earth with a
broken airplane xwing.
Bird with a broken wing he was,
and birds with broken wings never
could soar so high again.
Paul groaned. The night nurse, a
silent figure in white, a lantern bob-bing
by her side like a huge firefly,
laid her hand gently on his arm.
"What is the trouble, Mr. Dun-bar?"
"D d bird with a broken wing!"
Paul sighed half asleep, but not for-getful
of the pain in his left side
—
—broken wing. "Never fly again.
No more stories from the pilot's seat
of my plane—broken wings—
"
Paul's voice trailed off into silence
under the nurse's ministrations. When
she left him he was sleeping again,
peacefully this time.
Feature writer for one of his state's
best daily newspapers, and airplane
pilot good enough to have a transport
license, Paul Dunbar had been sent
three months before by physicians who
would hear of no other course to the
State Sanatorium suffering from a
moderately advanced tuberculosis le-sion
in his left lung.
Paul should have responded to twen-ty-
four hours a day rest in bed in a
number of weeks, but he did not. The
January, 1930 The Health Bulletin 15
lesion began to look as if it might be-come
worse, and the physicians in the
institution decided to administer pneu-mothorax.
Far from being a model patient
Paul had objected at first, but had
finally acquiesced. He had received
his first treatment the day before the
night he had had his dream of dash-ing
from a great heighth in an air-plane
with a broken left wing.
Eighteen months of the sanatorium
and Paul was in the superintendent's
office receiving his final examination
and instructions before leaving the in-stitution
to resume his life back in
the world of men and women outside
the san's wall.
Paul was now what the doctors call-ed
a quiescent case of tuberculosis. He
would have to have the pneumothorax
treatments continued, and he could
work only a few hours a day. He sup-posed
he should feel thankful that the
"bugs" had not gotten him, but in
Paul's breast there was a dull, glow-ering
resentment.—"The bird with the
broken wing never soars so high
again."
—And sitting in the superintend-ent's
office listening to his final words
of instruction, Paul was dully aware
that back in the world again he would
be a bird with a broken wing, who
would never be able to soar so high
again. For the doctor said emphatical-ly:
"No flying for two years."
It had been nearly two years now
since he had flown, strong and well
up there against the sun. Two more
years, four years before he could fly
again! Was it worth it?
As Paul watched an army plane
skimming over the hazy blue hills
that surrounded the sanatorium he
felt for a moment that he had fought
in vain.
But the doctor had said he might
return to his work on the desk for
part time. Part time on the desk, he
who had been his paper's star report-er,
free to go in his plane to the ends
of the earth if he could find there a
story for his paper, was to be a desk
man, writing news that other report-ers
gathered, and handling copy that
the fellows who could get out on the
streets were too busy to write. Not
yet twenty-five, he had run his gamut,
was played out before his time, and
all because of that bad lung—d—
n
broken wing!
The fellows on The Ashton News
were nice to Paul. Nice because they
were sorry for him, he thought, as
deaf old Henry Clinard carefully
wrote down for him the information
about that Draketown Street robbery
the reporter had brought in before he
arrived, to make sure that he would
understand everything connected with
it.
Watching "Old Henry" Paul won-dered
how it would feel to never be
able to hear a sound.
"Not so bad," Henry had once vol-unteered
the information, "if you
don't get cross with people who holler
at you. Deaf folks don't like to be
On the Stump in Guilford.
16 The Health Bulletin January, 1930
bawled at any more than folks who
can hear do."
After that Paul was always very
careful to write out his communica-tions
with Henry, or to talk in a tone
of voice that would make the old
copy-reader feel that he was not bawl-ing
him out. Henry appreciated Paul's
thoughtfulness, and there were many
times when Paul's work would not
have been completed in the few short
hours he was on the desk if it had not
been for Henry's aid.
Gradually there grew up between
the deaf copy reader and the young
re-write man with the broken wing the
close bond of sympathy that always
unites the incapacitated regardless of
what the nature of the trouble is.
The first day Paul was back at his
old position he noticed a flower and
gift shop that had been opened up in
his absence in the little niche next
door to the newspaper office. It was
spring, early spring, and the first
yellow jonquils were blooming. The
little shop was filled with the bright,
sunny beauty of the yellow flowers,
and just behind them stood a girl,
whose hair was as sunnily golden as
were the delicate petals of the jon-quils,
and the smile she gave Paul
from dewy blue eyes, Paul was willing
to swear, was made of pure gold it-self.
"How much are they?" Paul found
himself vaguely indicating the whole
gorgeous display.
Again Jonquil smiled, for Jonquil
her name must be, she was so much
like the flowers.
"Twenty-five cents a dozen, or three
dozen for fifty cents," and she had not
finished speaking before Paul decided
that her voice was as flowerlike as her
face and her smile.
"O, give me all of them," he said
carelessly.
"All of them?" A puzzled frown
crossed the sweet, little face, some-thing
like a brisk wind blowing across
a bed of flowers.
"All of them!" Paul repeated em-phatically
after her.
"That will be $10, sir."
And Paul thought that her talking
of prices was as if one of her yellow
flowers had stepped out of its vase to
do business.
"Where shall I send them, or will
you take them?"
Paul looked puzzled for a moment.
The jonquils would overflow his one
room, bath and sleeping porch. "Send
them out to the Bausman County Tu-berculosis
Sanatorium," he said quick-ly.
"To anyone in particular?"
"No, to all of the patients."
"What shall I put on the card?"
"From a 'Broken Wing,' only." Paul
did not realize that his voice was bit-ter.
The girl smiled in quick sympathy,
and for a moment Paul's black mood
lifted.
"Say, isn't your name Jonquil?" he
asked impulsively.
"No, it isn't, I'm sorry, but—" she
stopped.
"I'm going to call you Jonquil."
"When?"
"Now, and every time I see you
—
you see,—" Paul suddenly found he
was floundering helplessly. "I work
next door on the newspaper."
"O, you're a reporter?"
"Yeah, sort of."
And with that Paul tipped his hat
and went into the office. He had found
suddenly that he would not like for
this golden, blue-eyed Jonquil to
think of him as a man with a broken
wing.
Paul had been back on the desk at
The Ashton News for three months
when Lon Dale, the greatest airplane
stunt flyer in the United States came
to Ashton. Paul had flown with Dale
in the days before he had known that
he had lungs.
The stunt flyer's air antics and the
reporter's ability at description had
given The News many good stories.
Dale and Paul, who were very fond
January, 1930 The Health Bulletin 17
of each other, were delighted to meet
again. It had been two and one-half
years since they had pulled one of the
hair raising airplane stunts. They had
not been together fifteen minutes be-fore
they were planning one of those
thrilling flights of the old days, Paul
forgetting once again that he had
lungs—that he was a bird with a
broken wing.
They buttonholed Bill Lacates, the
managing editor, as he came in. It did
not take them long to tell him what
they wanted. A story in The News that
Dale was back, and that he and the
reporter were going to give again some
of the stunts that had given Ashton
citizens such a thrill three years be-fore.
Bill listened, chewing the end of a
villainous black cigar.
"Sounds fine, Dale," he disregarded
Paul, "if you can get someone to go
up with you to cover the flights, as
Paul used to. Paul's not well, you
know. It would never do for him to at-tempt
it."
Dale's face fell, and Paul grew
pale, his eyes blazed. "Bill, you have
no right to say I'm not well enough
to get that story, any d—n story I
want to."
"Remember, Paul, you're a desk
man now, and I'm the only one who
can tell you to go outside, and I'm not
going to tell you."
With that Lacates walked into his
office, and Paul was left facing Dale,
white and shaken.
"I'm just a bird with a broken wing.
Dale. I can't even fly now by my doc-tor's
orders. For a minute I forgot.
Bill is right. That was his way of tell-ing
me, 'I'm no good'."
"Sorry, old boy," Dale rose and
shook Paul's hand. "I was looking for-ward
to some of our old stunts, but we
won't now."
Paul sat at the re-write desk,
smouldering resentment in his eyes
when Dale had gone. The managing
editor had really been kind not to let
him attempt the dangerous physical
strain the gathering of the material
for the air stories would entail, but
Paul did not want kindness, sympathy.
He wanted his old red-blooded strength
back. He didn't want to be a bird with
a broken wing.
It was the night of the afternoon
that Paul's managing editor had re-fused
to let him take the air assign-ments
that Paul learned that Jonquil
was crippled, and that her beautiful,
white-haired mother was blind.
He left the newspaper office, walk-ing
by the little flower shop with
dragging footsteps.
"Hello!" It was Jonquil, whose real
name was Marta Sennett, the flower
shop girl.
Since the day in early spring when
Paul had bought her total available
supply of jonquils all at one time,
the girl had not forgotten Paul, nor
had Paul forgotten her.
To speak to her every day, and to
stop in the shop a few moments to
talk to her was almost a ritual with
Paul—and with Jonquil, too, if he had
known.
Further than the greetings and
flower shop conversations the affair
had never progressed. Whenever Paul
thought of knowing her more inti-mately
he immediately became hot,
then cold.
A fellow with a broken wing had no
business being more than the most
casual of friends to a girl like Jon-quil.
But tonight things were different.
Jonquil had invited him around to her
home, because she told him her moth-er
was celebrating her fiftieth birth-day,
and she had been looking for him
all day to invite him to the party.
Mrs. Sennett was seated by a win-dow
that looked down on the street
when Paul let himself into the little
apartment in response to her invita-tion
to come in when he had knocked.
She called cheerily to him to come
across the room to her chair, telling
him that she knew who he was.
When Paul took the soft hand of
18 The Health Bulletin January, 1930
Jonquil's mother, and looked into the
eager face raised to meet his, he real-ized
with a start that she was blind.
Reverently Paul took the white
hand, and bending touched it with his
lips. He wondered why Jonquil had
not told him before that her mother
was blind.
Paul's surprises were not at an end.
As Jonquil came from the kitchen of
the little apartment, stripping off her
work apron as she walked, he saw
that she was crippled. Her left foot
and leg to the knee was horribly de-formed.
Looking at her Paul thought that
he had never before seen Jonquil out
from behind her flower counter. Crip-pled
herself, her mother blind, she
supported them both with the little
flower shop. Brave, gallant girl! No
wonder he had thought she was like a
flower when he had first seen her. A
wave of tenderness swept over him. He
wanted to go to her, to lift her in his
arms, and carry her so she would nev-er
have to use the hurt limb again.
TTien his high mood fell. Bird with
a broken wing, he was not even able
to lift her slender body once, much
the less care for her all of his life
as he wanted to.
Paul touched Jonquil's slim, little
hand softly. The blue eyes on his were
questioning.
"It has always been that way," she
said in simple explanation, looking
down at the deformed foot. "You do
not mind that I did not tell you." She
indicated her leg and foot, her moth-er's
sightless eyes. "Mother and I don't
like to talk about it. We play all of
the time that we are both well and
normal, and it makes everything much
happier for us."
Paul suddenly knew that her warm
little hand was still in his. He pressed
it quick and hard. "You wonderful
girl. Jonquil."
Paul was happy, happier than he
had been in a long time when he left
Jonquil and her mother that night.
Though happier he left railing mental-ly
against fate, life, whatever force it
is, that sends young men out to fight
life with broken wings, cripples beau-tiful
young girls, makes blind lovely
old women, and deaf good fellows like
Henry Clinard.
Passing by Dr. Herndon Benson's
home, Paul saw a light burning in the
doctor's office at the side of the
house. Doc had been a good friend to
him all along, even when he had in-sisted
on his going down to the san-atorium.
He would stop in and talk
to the doctor, see if the physician's
training, and the hard philosophy of a
medical man could help him to solve
some of his problems.
It was late, but Dr. Benson received
Paul with a smile.
"My, you're looking fine, young fel-low.
Weigh more than you did before
going to the San, don't you? Not so
bad this business of having one lung
after all, is it?"
Paul frowned. "Mighty tough, doc-tor,
when you want to do something
so bad you can taste it, and people
tell you that you can't because of your
lungs."
The doctor looked thoughtfully
down at a test tube in his hand. "Paul,
to some degree almost every man, wo-man
and child living is physically in-capacitated.
It may be only a very,
very slight trouble, but the physical-ly
perfect man or woman hardly ex-ists
at all, any doctor will tell you."
"Guess that's true, doctor, but they
don't have to go dragging around crip-pled
wings like my lung, have deaf
ears, sightless eyes and deformed
limbs," Paul spoke bitterly.
Dr. Benson carefully laid down the
test tube. "You are right at that, Paul,
but did you ever think of the large
number of people who fight organic
troubles? I myself have a bad heart. It
has been bad since my high school
days. My wife suffers from high blood
pressure, and has to stay away from
many social functions she would like
to attend. My oldest son can't play
high school football because of
January, 1930 The Health Bulletin 19
chronic bronchitis. Loretha, my daugh-er,
is underweight and everyday of
her life the food she has to eat is a
trial to her."
"I know, doctor, but those are all
disorders than can be cured."
The doctor shook his head. "Some-times
they can, sometimes not. We all
have our lives to live, Paul, making
them as worthwhile as possible, re-gardless
of whether all of our phy-sical
organs are in perfect order or
not. Perhaps some day we will breed
a perfect race, a race that will not
have to be bound down to earth by the
needs and the disabilities of our phy-sical
bodies today. That time has not
come yet, and those of us who are liv-ing
now have to give our bodies the
best care possible, paying particular
attention to the weakest members.
Then forget we have a body at all,
and live our lives in spite of physical
disabilities."
Paul got slowly to his feet. "There's
a lot in what you say, doctor. I haven't
seen daylight yet, but I'm going to
think things through. I hope 111 be
able to see as clearly as you do, when
I have thought them through."
"You will, Paul," the doctor laid
his hand fondly on the erect shoulders
of the tall young man. "Best of luck!"
As Paul walked homeward through
the night the physician thought what
a lucky chap Paul Dunbar was. Twen-ty-
five years ago his disease rapidly
advancing he would have probably
died. Now, modern medical science had
saved him, as firte a looking specimen
of young manhood as could be seen on
the streets.
The broken wing, Paul so bitterly
complained of, the doctor felt sure
Paul would find less of a disability as
time went on. He would learn to live
his life despite the broken wing.
In the gray dawn of the morning
after Paul had been to Jonquil's moth-er's
birthday party, and talked to Dr.
Benson, he wrote the editorial "Brok-en
Wings" that won for him that
This distinguished Jackson county couple are 82 and 85 [icars <>/ <ii/e re-spectively.
They have been inarried 57 years. They owned the second antomn-hile
in Jackson County. They still drive their oivn car and travel irhere they
please. The husband operates a large farm and store. They lire in their own
home but drive down town every nice day for a hotel dinner. Roth of them
read the newspapers and take a vital interest in all the affairs of the day.
20 The Health Bulletin January, 19SO
year's prize for the best editorial writ-ten
in the United States.
Donald Heitman, editor of The
News, found the editorial on his desk
and blinked when he saw the name.
Dunbar writing editorials? Well, he
would read it, and if it was passable
he would use it, give the boy a bit of
encouragement.
Heitman slowly read
:
Broken Wings
"The bird with the broken wing nev-er
soars so high again."
The airplane up against the sun,
a wing broken dives swiftly to de-struction
for itself and its occupants.
Human beings, blind, deaf, crippled,
with bad lungs, hearts and defective
bodily organs, armless, legless, or in
some way incapacitated are birds
with broken wings—birds that can
never again soar up against the sun.
To some degree all of us are in-capacitated.
Physical perfection, one
hundred per cent is rarely ever found.
The wing broken, the machine dis-abled,
shall the incapacitated give up,
say life is over? No!
Modern medical science has gone a
long way toward mending the broken
wings of the physically and mentally
incapacitated. The church has always
done its share in binding up spiritual
wounds.
The broken wing mended one must
go on, forgetting—if he can—that it
was ever broken.
—But it is impossible to forget the
broken wing. Its strength is gone. It
is not the same wing—"The bird with
the broken wing can never soar so
high again!"
True, he can not soar up against
the sun, but what of the earth ! All of
us are closely bound to earth. The air-plane
gets only a very small portion
of us away for a short time, from
down there against the earth where
we live. The broken winged must find
interests upon which he can center his
thoughts. Interests close to earth. He
can not keep his thoughts bottled up,
thinking of the wing that Is not work-ing
just right. He must forget he has
a broken wing in the joy of living,
not because, but in spite of something
gone wrong.
Someone to love deeply, a hobby, mu-sic,
reading, pets, flowers, a garden
will all aid in throwing thoughts that
might become morbid off their sinister
trail.
You are not a bird with a broken
wing, but a normal, whole, happy in-dividual.
Happy with one's work, and in one's
home the morbid thoughts seldom find
time to enter, and when they do they
do not stay long, where the sun i;hat
filters down to earth is allowed to
come in.
The broken winged bird may never
fly again, but the memory of the days
when soaring up against the blue the
earth was green below, the sun gold
on his wings can never be taken away.
—And who knows, the bird with a
broken wing may be able to soar up
against the blue with the sun on his
wings, again sometime!
There was an offer of a job from
several big city papers after Paul's
editorial won the prize. When his home
town paper offered him the place as
city editor with a salary large enough
to support a wife and family on, Paul
refused the big city job, and stayed on
in Ashton.
Before he accepted the new position
on The News he walked out to talk
things over with Jonquil.
"Must I take it?" he asked.
"Take it? Why you know you'll take,
Paul!"
"If I accept the place will you give
up your flower shop and marry me?"
The dewy blue eyes had never been
more flowerlike, as she raised them to
Paul. "If you insisted long enough,
and hard enough, I might."
"Even if I am a bird with a broken
wing?"
"Hush!" Jonquil placed her fingers
January, 1930 The Health Bulletin 21
lightly on his lips. "At our house we're
going to play we're always well. I
wouldn't marry a man with a broken
wing, even if he were an angel, and
I know you wouldn't think of even
looking at a girl with a crippled foot,"
Jonquil teased brightly as Paul sil-enced
her with a kiss.
VACCINATION FACTS
By
Frederick R. Taylor, M. D.
Vaccination against smallpox was
the first great discovery of preventive
medicine. In 1798 Dr. Edward Jenner,
an English country doctor, after fif-teen
years of painstaking observation
and record keeping, published his
epoch-making paper entitled "An In-quiry
into the Causes and Effects of
the Variolae Vaccinae, a Disease Dis-covered
in Some of the Western Coun-ties
of England, Particularly Glouches-tershire,
and Known by the Name of
the Cow-pox." The modesty of this
great benefactor of mankind is shown
most impressively in Jenner's reply to
a Mr. Cline of London, who promised
him the stupendous sum of 10,000
pounds a year income if Jenner would
consent to settle in London. Jenner
replied to this offer, "Shall I, who
even in the morning of my days sought
the lowly and sequestered paths of
life, the valley, and not the mountain;
shall I, now my evening is fast ap-proaching,
hold myself up as an object
for fortune and for fame? Admitting
it as a certainty that I obtain both,
what stock should I add to my little
fund of happiness? My fortune, with
what flows in from my profession, is
sufficient to gratify my wishes; in-deed,
so limited is my ambition, and
that of my nearest connections, that
were I precluded from future practice,
I should be enabled to obtain all I
want. And as for fame, what is it?
a gilded butt, forever pierced with the
arrows of malignancy . . . ."
What has vaccination really accom-plished?
The following data are copied
from the article on Vaccination by
Professor George Dock in the second
edition of Osier and McCrae's "Mod-ern
Medicine." He writes:
"Coincident with the rapid spread
of vaccination was a marked fall in
the extent and mortality of smallpox
all over the civilized world—. In Lon-don,
in the years 1761-1800 the mor-tality
in the successive decades was
respectively 24,234, 20,923, 17,867,
18,477. In the first two decades of the
19th century it was 12,534 and 7,856.
Toward the end of the second decade
of the 19th century smallpox began
to increase, and in some countries be-came
almost as prevalent as it had
been before. The causes of the recrud-escence
are not difficult to understand.
Many people had been vaccinated so
long before that they had lost their
immunity wholly or in pai-t. This was
the time to settle the question as to
the life-long protection which the
early vaccinators so fondly believed in,
but prejudices were still too strong.
Many other people were not vaccinat-ed
at all, because smallpox was so
much less frequent that the operation
seemed unnecessary, and there was a
smaller proportion than before not
protected by smallpox." (One attack
of smallpox, when it does not kill,
protects against subsequent attacks.)
"Looking back, it is clear that cer-tain
great changes had occurred in the
smallpox situation since Jenner's dis-covery.
The absolute mortality was
less; the disease was not so frequent
as before in the years following the
usual age of vaccination; and these
facts were most obvious in countries
22 The Health Bulletin January, 1930
that had the most thorough vaccina-tion.
The change in the age-incidence
is interesting. Smallpox was common-ly
spoken of in Germany in the pre-vaccination
days as "Kinder-pocken'
(children's pox). Of 1252 cases of
smallpox before vaccination 94% were
in children less than 10 years of age,
and no case above 20. Of 1677 cases
after vaccination, only 18% were und-er
10 years of age, and 42% over 20.
Epidemics were smaller, and mild
cases, long known, but rarely men-tioned,
became relatively more fre-quent
"In this period revaccination be-gan.
Suggested early in the century,
it was long neglected. Certain German
states first applied it to their arm-ies
"The most striking test of the pos-sibilities
of vaccination was made in
the war of 1870-71, and depended
largely upon the far-sighted care of
the German military authorities.
Smallpox became so prevalent in
France in the pi'eceding winter, that
effoi'ts were begun to combat it, but
the outbreak of the war not only pre-vented
such action, but as usual caus-ed
a great increase of the disease
which rapidly extended over Europe.
In Germany, v/here many prisoners of
war carried the infection, the disease
was widespread; but it was a striking
fact that the German soldiers were not
only less frequently and less severely
affected than the French, but that they
were less affected than civilians of mil-itary
age in the same towns. The only
difference was that all the German sol-diers
under arms at the outbreak of
the war had been revaccinated within
two years. The following figures show
the mortality of different classes at
that time: revaccinated 5%, once vac-cinated
14%, unvaccinated 45 7f. This
object lesson was not lost on the newly
formed German Empire. In 1874 the
first law was passed providing for the
vaccination of every child before the
second year, and of all school children
in the twelfth year. The result of the
operation was to be a matter of record,
and failure to produce a satisfactory
vesicle necessitated a repetition. In the
civil population the mortality sank
rapidly, so that in 1910 the deaths
in the whole empire was only 33 (15
being foreigners)."
The woi'k from which the above is
quoted was published in 1913.
Cecil's Text-book of Medicine by 130
American authors, published in 1927,
has a chapter on vaccination by Prof.
D. Murray Cowie. The last two para-graphs
of his chapter show how little
smallpox can be influenced by the best
methods of sanitation and quarantine,
and how completely it can be con-trolled
by vaccination. They read as
follov/s
:
"In no country since the discovery
of vaccination have as rigid sanitary
measures been carried out as in Eng-land—
notification, strict quarantine of
patients and contacts, and careful dis-infection.
On the other hand, in Ger-many
where more attention has been
paid to vaccination and revaccination,
the death rate from smallpox has
been much lower. From 1875 to 1905
England and Wales had 8,342 deaths
compared vv'ith 1,115 in Germany
(Schamberg). Vaccination and revac-cination
became compulsory by law
in Germany in 1874. Since that time
smallpox has ceased to be an epidemic
disease. Unquestionably, vaccination
and revaccination is the most import-ant
method of stamping out the dis-ease.
"General Leonard Wood records the
experience of two battalions (700 U. S.
soldiers) in Holguin, Cuba, in 1898:
'A large number of American sol-diers
under a fair state of discipline
was sent into a country infected with
the most virulent type of smallpox,
where the death rate was heavy and
all sanitary conditions were against
them, and although living for months
in towns infected with the most ma-lignant
type of smallpox, to which
they were constantly exposed, not a
single case occurred in the regiment'."
January, 1930 The Health Bulletin 23
Yet, there are still some people who
oppose smallpox vaccination! It is
very difficult to see why this should
be so. Two arguments are advanced
in objecting to vaccination that are
thoroughly fallacious. These are:
1. That smallpox is now so mild
that vaccination is unnecessary,
2. That vaccination itself is occa-sionally
fatal.
Let us consider these supposed ob-jections
for a moment.
1. Any infectious disease that can-not
spread fast usually becomes of a
milder type. Smallpox is no exception
to the rule. However, smallpox is get-ting
milder only because vaccination
prevents its rapid spread. Experience
has shov/n repeatedly that where vac-cination
is neglected, smallpox begins
to spread more rapidly again and be-comes
as deadly as ever. Moreover,
even where it is usually mild, some
severe and fatal cases are sure to ex-ist.
2. Vaccination is occasionally fatal,
as is sewing with a needle, as prick-ing
the finger may be fatal. The risk
is, however, so nearly absolute zero
as to be absolutely negligible—not for
01 e moment to be compared with the
risk of riding in an automobile. It is
not even to be compared to the risk of
going down one's steps at home—
a
performance that kills or cripples
some people every year. Smallpox is a
serious risk, on the other hand.
If everyone were simultaneously
vaccinated, smallpox could be literal-ly
wiped off the face of the earth,
and the germ that causes it would be-come
as extinct as the mastodon or
the saber-toothed tiger, and would nev-er
again plague mankind.
Let's all get vaccinated!
COLLEGE BLUES
By
Karl A. Menninger, M. D.
Each year thousands of college stu-dents
fall by the wayside. The wise-acres
have many explanations and
very little remedy. Too riiany stu-dents
are going to college. The pace is
too fast. The ideals are wrong. The
faculties are incompetent. The curri-cula
are inappropriate. Above all there
is too much money and too much friv-olity
and too much social life. College
students have much too good a time.
The mental hygienist is somewhat
out of sympathy with these explana-tions.
He does not deny that some of
them may be true but his pragmatic
sense is offended by the futility of
generalization. His whole point of
view is individualistic. Leaving prob-lems
of curriculum and world politics
aside, he is interested in what has put
a particular John Smith and Mary
Baker out of the running. The loss of
John Smith may mean little to the
college; the loss of Mai-y Baker may
not greatly distress the world, but
some of these Johns and Marys are
worth saving if any one is. The boy
or girl who gets to college is one in
a hundred. He is engaged in a period
of enormous importance to himself be-cause
it is his preparation for a spe-cialized
contribution to the world. For
the same reason it is a period of
enormous importance to the world.
For the past ten years psychiatrists
have been trying to make people un-derstand
that mental hygiene is not a
matter of preventing insanity. Psy-chiatrists
are not particularly inter-ested
in insanity any more. Of course
the insane are numerous; in fact, they
quite outnumber the college students.
But far more numerous are the un-healthy
minded. By the unhealthy
24 The Health Bulletin January, 1930
minded we mean the unadjusted, the
unhappy. One of the Survey's contrib-utors
some time ago wrote under the
title, "The unhappy are always
wrong." This is true. At any rate the
unhappy are always in need of mental
hygiene, whether their unhappiness is
conscious or not. There are lots of
mentally unhealthy people who are not
unhappy but who ought to be. These
too are included in the mental hygiene
program of today.
Mental hygiene aims at the preven-tion,
the deflection one might say, of
human failure. If it is to be effective
its efforts must begin months, if not
years, before the student flunks out
of college, or has a nervous breakdown
or shoots his room-mate or enters an
asylum, or arrives at some other
shocking and often irrevocable ex-tremity.
Consider for a moment what the
college freshman faces. He leaves the
high school to enter a college. From
being a senior with all that it means,
he becomes a freshman with all that
it in turn implies. From town or coun-try
he may transport himself to a
city, and to a very sophisticated and
complex group within the city. From
living at home, with all the protection
and consideration which that includes
he enters a rooming house or fratern-ity
house. Meanwhile he (or she) is
changing physically. The average col-lege
freshman is almost, but not quite
an adult physically. This state of al-most
is very difficult, as every one
knows except those who have never
reached it. Then, too, there are ac-quaintances
to make of the same and
of the opposite sex, and there are cer-tain
attitudes to be taken and certain
gratifications to be sought and certain
new lines of inhibitions to be set up
and certain old ones to be broken
down. There is practically a new spok-en
language to learn and a new set
of taboos and a more or less thorough-going
revision of aims and ideals.
In addition to these general prob-lems
college students have a lot of
specific problems about which the out-side
world knows nothing or which it
judges unsympathetically. There are
problems of athletic ambition and dis-appointment:
the world hears only of
the successes. There are problems of
Greek letter fraternities, both inside
and out, which only one in close con-tact
with students can fully realize.
There are problems of love affairs
dealt with in the immature fashion to
be expected at this stage, but also with
an intensity which the unsympathetic
may easily underestimate. There are
problems of jealousies and envies in-side
and outside of the family, con-flicts
with parents, special antipathies
to subjects and instructors, religious
problems, curricular problems, physic-al
problems real and imaginary, life-work
problems, racial problems, eco-nomic
problems; in fact all the prob-lems
the older people confront, plus a
great many more. Think of all this
faced by a freshman student of only
average intelligence, of average emo-
Folks, please meet the New Sister
of oio- two old friends from Greens-boro.
January, 1930 The Health Bulletin 25
tional control and average ability, at
the average American college or uni-versity
at the average age of eigh-teen.
Surely it is not surprising that
some of them have "adjustment diffi-culties"
and are sent to the mental
hygiene counsellor or seek his help
voluntarily.
—
Survey Graphic.
OUR LIVES SHORTER, NOT LONGER
So at least concludes C. H. Forsyth
of the Department of Mathematics at
Dartmouth College, from recent sta-tistical
studies, whose results he pre-sents
in Science (New York). The
average lives of the young have been
increased, but the old die earlier. Un-less
adults can manage to live more
sanely, it will be a losing fight for the
elderly, he concludes, at least for some
time to come. Those who feel justified
in predicting marvelous increases in
the average length of life have failed
to appreciate, says Mr. Forsyth, that
practically all reductions in the death-rate
have been in children's diseases,
and that little or no attention has
been given to ages beyond the prime
of life. He finds that conditions in this
country at advanced ages have long
been on the down grade, and that the
great gains at early ages are already
more than offset by the losses at ad-vanced
ages. In brief, the surprising
conclusion is that the average length
of life in this country is now actually
decreasing. Writes Mr. Forsyth:
"The main results were obtained
from abridged mortality tables con-structed
from the statistics of the
males of the ten original registration
States—the new England States and
Indiana, New Jersey, and New York
—the only States which have sup-plied
satisfactory records since 1900
—and even 1890. The results for fe-males
are not given here, but present
the same picture—in somewhat less
smooth form.
"It will be understood, of course,
that there is an average length of life
corresponding to each age—the aver-age
length from that age on—al-though
it is usually called the expec-tation
of life in that case. In working
with abridged mortality tables it is
necessary to omit the first few ages
—
say, before the age of ten—for well-known
reasons, but the expectation
at age ten is usually a rough approxi-mation
of the average length of the
whole of life.
"During the thirty years from 1890
to 1920 the expectation of life at age
ten—and therefore approximately the
average length of life—increased
markedly. The results for 1920 proved
a little disconcerting for a time, for
that year showed not only unexpected
improvement at the early ages but
also fairly satisfactory conditions at
advanced ages. The abnormality of
the year 1920 should have been appre-ciated
at that time, however, because
we were just recovering from the
'flu' of 1918, and the improvement
could have been easily explained as a
natural reaction.
"Every one has been familiar with
the consistent improvement of condi-tions
at earlier ages, and some have
been more or less aware of the situa-tion
at advanced ages, but there is no
printed evidence that any one was suf-ficiently
aware of the seriousness of
the latter situation to propose the
pertinent question of whether the
latter situation would ever develop to
the point where it would dominate. In
any case, the question is no longer per-tinent—
the decline at advanced ages
already dominates, and the average
length of life—or at least the expec-tation
from age ten—is already going
down. The curves for the years 1921
to 1927 inclusive tell their own story.
The expectation from age forty-five
or fifty on is the lowest of which we
have any record—far lower than it
was even forty years ago—and it is
still going down, not up.
"The changes in death-rates previ-
26 The Health Bulletin January, 1930
ous to thirty are not significant, and
although it might well be argued that
little significant change could be ex-pected
in a short period of only seven
years, by the same logic the changes
in the neighborhood of age seventy are
tremendous.
"It is well to recognize that im-provement
at the early ages has a
rather definite limit, and that the de-cline
at advanced ages has no appreci-able
limit. It follows naturally that
with all the improvement in the world
at the early ages the present down-ward
trend at the advanced ages, if
unchecked, will continue to dominate
and produce a greater and greater net
decline in the average length of life.
"The great decline at advanced ages
is remarkably concentrated about age
seventy, although it extends as far
back as age forty. To me, the whole
picture, from our earliest records in
1890, to the present time, points con-sistently
and inevitably to a future of
a declining average length of life until
the American adult wakes up to the
fact that the odds are at present heav-ily
against his living as long as his
father or grandfather. Some will say —and no doubt truly—that it is all a
natural consequence of the great drift
to the cities. Others will go farther
and say life has become too fast and
strenuous, and that we do not know
as yet how to adjust ourselves to such
a life.
"To the medical authorities the
whole problem will loom as one of re-lieving
the strain upon the heart. But
little will be accomplished until the
American adult himself is duly in-formed
and made to realize that he is
in the midst of a decidedly losing fight,
and that the situation will continue
unless he applies himself energetically
to be superior to his environment.
Moreover, each adult must fight his
own individual battle, since he usually
brooks no interference with his own
individual mode of living. Medical au-thorities
and scentists can be depend-ed
upon to care for the children and
their diseases, but they have little or
no chance to interfere with the lives
of adults.
"It truly looks as if it is going to
be a losing fight for some time to
come, for although some adults are
making a commendable effort to live
sane lives, the vast majority seem very
indifferent, and many give apparent-ly
no thought whatever to habits
which they clearly know are bad, and
which they know they could easily
discard. There is surely no worse in-fluence
than that wielded by well-meaning
authorities who go around
airing their ill-founded beliefs that
all is going fine and that before long
everybody is going to be living seven-ty-
five to a hundred years."
—
The Lit-erary
Digest.
COMMON SENSE AND THE OPEN WINDOW
By
Arnold H. Kegel, M. D.
Commissioner of Health, Chicago
Do you sleep with your window
open? Recent discoveries in the science
of ventilation throw interesting side-lights
on the ventilation of sleeping
rooms and tend to modify to a consid-erable
extent previous opinions and
practice.
Less than a generation ago we
heard a great deal about fresh air and
foul air. All outdoor air was labeled
"fresh," for want of a better term,
and air indoors was supposed to be
"foul." These terms are fast disap-pearing
from our literature. Flugge
January, 1930 The Health Bulletin 27
of Breslau, Germany, and Leonard
Hill, of England, have shown conclu-sively
that the bad effects in a poorly
ventilated room, the headaches, and
general feelings of discomfort, are not
due to some ms^hical substance in
the air that renders it foul, but to an
excessive temperature, a high humid-ity
or a combination of the two. Furth-ermore,
we have learned that the air
from out-of-doors is not always more
desirable than the air indoors. This
is particularly true in Chicago and
other large cities where the outdoor
air is constantly contaminated, par-ticularly
during the winter months,
with smoke, fog and dust from vari-ous
sources.
Do you sleep better with your win-dow
open? Analyze and consider this
question without prejudice or precon-ceived
opinion. Suppose you have a
north room provided with an ordinary
wooden sash double-hung window
without weather strips or a storm win-dow.
The weather is cold; Jack Frost
flirting with the zero mark on the
thermometer, and a moderate wind,
say ten miles per hour comes from the
north. The leakage of air into the
I
. room between the sash and casement
and between the upper and lower win-
; dows would be under these conditions
j about 60 cubic feet per minute with
the window closed. Now, an ordinary
adult requires for respiration about
one-third of a cubic foot of air per
minute. So, for the purpose of re-spiration,
the leakage around a closed
window will supply him with about
180 times the amount of air necessary.
But to promote circulation of air in
the room, and to ventilate in a satis-factory
manner hygienists have set a
standard of from 25 to 30 cubic feet
of air per minute for each person.
This is a very liberal allowance. With
a leakage of 60 cubic feet per minute
around a closed window under the con-ditions
mentioned, we still have twice
the amount of air required to ven-tilate
the room when occupied by one
person, or an ample supply for two
persons.
Let it be clearly understood, how-ever,
that we are not advocating as a
general proposition that Chicago's cit-izens
sleep with the windows closed.
We are only pointing out that in cold
weather there is no necessity for open-ing
the windows to any considerable
extent under the false impression that
this practice is necessarily desirable
or healthful.
By all means, sleep with the win-dow
open. Open it wide when the
weather permits. But do not make a
fetish or a fad of open window ven-tilation.
Do not boast to your friends
that your window is always wide open
irrespective of weather conditions.
This practice does not indicate the
best of judgment on your part. Direct
drafts, particularly when one is sleep-ing,
are productive of colds and tend
to increase rather than decrease our
death rate during the winter season
from influenza and other respiratory
diseases.
There is much the medical profes-sion
does not know about colds, but
there is ample evidence that a sim-ple
cold is a local infection of the
membrane lining the nose or throat.
Quick changes in temperature, uncom-fortable
drafts, or chilling of the body
upset or disturb the control of blood
flow to these parts and favors the
spread of infection. In this way a
simple cold becomes severe as the in-fected
area increases. If the infec-tion
invades the finer structure of the
lungs, pneumonia may be the result.
Rest in bed and a comfortable even
temperature are the best ways to treat
a cold and prevent serious complica-tions.
Use common sense in opening your
window. Young adults who are strong
and robust may profit by the prac-tice.
This, however, is not necessarily
so of children, of the aged, and of
many of all ages who are not particu-larly
rugged or are susceptible to colds
and drafts. And we strongly suspect
28 The Health Bulletin Janvury, 1980
that even the robust sometimes enjoy
good health in spite of the wide open
window in cold weather rather than
because of it.
Be comfortable with the window
open. Physical comfort should invari-ably
be your rule governing sleeping
room ventilation. If you sleep better
and awaken refreshed with the win-dow
open a fraction of an inch, that
is the best condition for your individ-ual
requirements. If you sleep better
with the window wide open and the
chilling drafts are pleasant rather
than disagreeable, by all means open
your window wide. But do not throw
open your window in cold and inclem-ent
weather and retire with chatter-ing
teeth and sleep with a blue nose
and general discomfort under the
mistaken idea that it is healthful.
A person may sleep in cold and
windy weather with the window closed
without the slightest fear of bad re-sults
from a deficient air supply. Leak-age
about and between the sash will
supply sufficient air for breathing
purposes. It is usually desirable, how-ever,
to have the window open to some
extent; the reason for this is not to
obtain more air, but rather to cool
the sleeping room to a comfortable
temperature and promote air circula-tion.
This should be approximately 10°
below that of the living rooms. I
One should understand that the im-portant
considerations in maintaining
healthful conditions in the sleeping
room are a comfortable temperature
and clean air. In many parts of the
city, the outside air contains an ex-cessive
amount of soot and dust. It is
advisable to use a cheese cloth screen
beneath the lower sash of the win-dow.
An ordinary fly screen can be
easily adapted for this purpose. The
wire screen is left in and covered with
a piece of clean cheese cloth. This
breaks up the strong currents of air
that produce unwelcome direct drafts,
and also filters out the greater portion
j
of the soot and dust.
—
Chicago Health
Bulletin.
DOSERS
By
D. E. Ford, M. D.
He poked his head around the edge
of the door and gazed hopefully into
the office. A strange presence pervad-ed
the room like a thin blue-green
fog.
"The Welfare Lady says will Dr.
Ford cure me."
"Working?"
"The fertilizer man says to keep
away 'till I'se cured."
The pain is evident as he limps into
the room.
"Mah blood's bad," he explains as
he begins to unwind oozy rags from
his legs.
The stenographer has vanished.
With the loosening of the dripping
bindings slices of side-meat slide to
the floor revealing large and luscious
ulcers up and down his shins. Perfect
specimens of ulcers—beautiful ex-amples
for a medical class.
I don't blame the fish factory for
casting him out. But why pick on me!
"How long have you been like
that?"
"Three months—maybe four; but
they want so bad then."
"Three months ! You've let your legs
rot like that for three months and
done nothing?" Stronger words may
have slipped out.
He straightens up; the worm is
turning, indignant at the false charge
of neglect.
"I've done everything every one told
January, 1930 The Health Bulletin 29
me! I've put on collard leaves and
vinegar, bread mash, fish meal, and
kerosene oil. I got a black salve at a
drug store, I've tried spider webs,
turpentine and side meat. I've done
everything anyone told me!"
He leaves the horrid impression that —along with the side meat—someone
told him to come to me.
He did everything every one told
him!
While the janitor is called to do the
proper things to doors and furniture,
the right things are done for the pa-tient.
He departs, leaving a specimen
of blood and a lingering impression
of a strong personality. He is to let
the bandage alone and to return in
two days—unless someone, meanwhile,
tells him different.
He did everything everyone told
him to do! Better men than he—and
women—do the same. Oh! how we
abuse our bodies and those of our chil-dren,
doing what well-meaning some-bodies
advise!
A tired feeling! A pain! Can't
sleep! Sleepy all the time! The baby
cries! The baby won't cry! Any con-dition
of body or mind. Free advice
gathers around. Friend or stranger
—
each has a sure-fire remedy. Free?
Why they beg you to take it ! Read the
glowing promises in the newspaper
advertising. Read the wonderful tes-timonals
on the colored wrappers of
the big bottles—testimonials that are
offered at so many dollars per hun-drd
for any medicine manufacturer
to buy.
Free? The advice only is free. Who
pays for the pages of advertising.
for the quarts and pints in funny-shaped
bottles on the druggist's
shelves and in the parcel post? The
dosers pay. The chronic dosers and
home remedy folks pay more every
year for useless or harmful stuff
than all the hospitals in the country
receive.
Illness, simple and easily cured in
the beginning, grow by ignorant neg-lect
and harmful dosing to serious
conditions. Finally someone trained to
understand the body is called—a doc-tor's
advice is sought.
When you want a dress made do
you patch it together on every neigh-bor's
free advice? No, you go to a
dressmaker, one whose business is to
know dresses. When you want your
house painted do you listen to the ad-vice
of the colored delivery boy whose
father used some paint once? No, you
get a skilled painter. When you are
in jail, you hire a man trained in the
law.
But when you run a fever for days
or have a chronic headache or most
anything—you follow the advice, first
of anyone not trained to know the
causes of illness. If one recommenda-tion
doesn't work another may be
tried until the sickness gets beyond
endurance.
Too often it is when strength is
gone and pocket-book is flat, after
everything freely advised—even to
"side meat"—has failed, that skilled
trained advice is hired. And too often
an immediate miraculous cure is ex-pected
for a condition which, though
simple at first, has progressed too far
for help.
—
New Bern Times.
OUR BACK COVER CARTOON THIS MONTH
We hear much discussion of the
present tendency of the younger gen-eration
to indulge to excess, or seem-ingly
so to their parents, in the fast
living incident to the present day. It
is probable that just such apprehen-sions
have been expressed ever since
civilization appeared on this earth.
Seriously speaking, it does seem to
this writer that many of our finest
young people are indulging to excess
in such pleasures as dancing and ci-garette
smoking, to mention no other
excesses. Excessive smoking indulged
in by boys and girls in their teens is
unquestionably detrimental to their
30 The Health Bulletin January, 1930
health. Excessive indulgence in the
pleasures of dancing, requiring much
loss of sleep, irregularities of various
sorts, to say nothing of the emotional
excitement, means that young people
indulging to excess are drawing from
their bank of health, resources that
they will need in later years.
The foregoing is merely introduc-tory
to the statement that our cartoon
this month is drawTi by a talented
young man who is at present serving
a term in the State's Prison. We know
nothing of his guilt or innocence, but
we do know that he is in position at
present to observe some of the dis-asters
that overtake young people who
lose their balance and embark on a
course liable to end in disaster.
HOW VERY TEW OF US DIE
By
WM. BRADY, M. D.
Probably many readers know that
when I think anybody or anything is
wrong I like to say so in print. Not
so many know that I apply this policy
to myself when I happen to be the
wrong one, for now and then I have
been wrong and I have acknowledged
it fi-eely and just as soon as I could.
Met a man connected with the life
insurance business, and he seemed
surprised that I oppose a departure of
certain insurance companies that is
variously called health conservation,
longevity service, and the like. I told
him that primarily I objected, as a
buyer of insurance, to paying the ad-ditional
cost of such service; and sec-ondarily
I do not believe all of this
adventuring by insurance companies
in other fields of work has any tan-gible
effect on the health of their
policyholders.
My friend came right back there.
He assured me that the statistics were
available to prove that this health or
medical work by the insurance cor-poration
actually lowers the cost of
insurance to the public, to the indi-vidual
buyer. There he had me, for in
all fairness I was compelled to reply
that if I were convinced of that I
should cease opposing these activities
of insurance companies and become a
booster for such practice. Insurance
of all kinds is a great boon and for
comfort and peace of mind while we
live and the well being of our loved
ones after we've passed along. I say
with all fervor "God bless the life in-surance
business." In the same spirit
I maintain that the use or administra-tion
of funds in the insurance com-pany's
keeping is a matter that is your
business and mine, and up to the pres-ent,
or until I met this man I refer to,
I have felt quite positive that this ad-venturing
in health, in public health
activities, in what should be private
medical practice matters, is an un-justifiable
diversion of funds, and ac-cordingly
I have opposed this fad of
certain insurance companies whenever
my views or advice have been sought.
Well my good friend saw to it that
the cold figures were placed in my
hands. They were impressive figures,
too. The mortality rate, that is, the
number of deaths, occurring among
each thousand persons in the year, is
given in a chart, first that of the pop-ulation
of the country at large, and
alongside it the rate among several
million policyholders of this particular
company. It shows that the death rate
among the people at large was rather |
lower than that of the policyholders i
in every year from 1911 up to 1925.
j
In 1925 the insurance company's rate
January, 1930 The Health Bulletin 31
finally got down to that of the whole
country, and in the past three years
the policyholders have been holding
out a little better than the people at
large.
At first glance such figures might
seem to justify the argument that this
health work by the insurance com-pany
lowers the cost of insurance to
the buyer for of course the premium
rate on your insurance is determined
by the death claims the company has
to pay. But the figures must be inter-preted
with the fact in mind that the
policyholders are selected risks, and
the many applicants rejected as poor
risks must figure in the mortality rate
of the population at large. These con-siderations,
it seems to me, invalidate
the argument that this health adven-turing
by the insurance corporation
lowers the cost of life insurance. To
draw that conclusion it would be
necessary to ignore the effect of all
public health and in fact all other ac-tivities
or work than that done by the
insurance corporation. — Ealeigh
Times.
AN ENCOURAGEMENT
The deathrate for tuberculosis dur-ing
the first half of 1929 was unpre-cedently
low for this part of any year.
The rate for white policyholders was
only 73.6 per 100,000. This marks a
decline of 3.3 per cent over the record
for January-June, 1928. There was,
also, a 7.8 per cent drop for the col-ored
insured. These new declines have
taken place despite the influenza out-break
which was responsible, during
the first quarter, for hastening the
deaths of large numbers of tubercular
patients. It is now assured, almost be-yond
peradventure, that the end of
1929 will see another new minimum
mortality figure for tuberculosis in the
United States and Canada; and that
this figure will be well below the form-er
low point established only last
year.
Heart Disease Leads All The Rest
The "Degenerative" Diseases
The combined deathrate for the
three principal "degenerative" condi-tions
(heart disease, chronic nephritis
and cerebral hemorrhage) rose slight-ly
as compared with the first half of
last year. This was due entirely to an
increase for heart disease.
Deathrates from Alcoholism, Cirrhosis
of the Liver and Acute Alcoholic
Poisoning Are All Increasing
Alcoholism, exclusive of acute poi-soning
by wood or denatured alcohol,
was the reported cause of death of
321 Metropolitan Industrial policy-holders
during the first six months of
1929. This number corresponds to a
deathrate of 3.4 per 100,000, and
marks an increase over the corre-sponding
period of last year, when
there were 284 deaths and a deathrate
of 3.1.
The deathrate from alcoholism con-tinues
to run much higher in the in-dustrial
population of the United
States among Canadian wage-earners.
This has always held true—both be-fore
and since National Prohibition.
Of the 321 deaths from alcoholism, so
far this year, only six affected Can-adian
policyholders, who number ap-proximately
one and one-quarter mil-lions.
Since January 1, 1922, a pe-riod
of seven and one-half years, there
occurred 3,818 deaths from alcoholism
among Metropolitan Industrial policy-holders.
Only 43 of these were deaths
of Canadians.
Six hundred and fifteen deaths were
reported from cirrhosis of the liver,
which is closely associated with alco-holism.
The deathrate was 6.6 per
100,000. During the like period of 1928
there were 578 deaths, with a rate of
6.3. Deaths from acute poisoning by
wood or denatured alcohol are of little
importance numerically, but have late-ly
been showing a tendency to in-crease.—
Fro?H Statistical Bulletin,
Metropolitan Life Ins. Co. 1929.
ff
^HE. YOUNGER GENERATION ARE SWIFTLY SENDING THEMSELVES TO
AN EARLY GRAVE BY THEIR RIOTOUS LIVING,'^ SAYS NEWS tTEM.
• ^ ^'S^^p^sj^abq Tnn.^°RmCAR9LI^A SWE.DPARDs^^E^Cm
1 This Bunelir\wi];!be 5er\l free to arwj citizen of Ihe 5tcrteupoi\Teque5t. |
Entered as second-class matter at postoffice at Raleigh, N. C, under Act of July 16,
1894. Published monthly at the office of the Secretary of the Board, Raleigh. N. C.
VOL. XLV FEBRUARY, 1930 NO. 2
For a number of years we have been proclaiming the desir-ability
of utilizing home-made equip^nent for playground exercises.
Here at a two teacher school in Columbus county is a fine example
of the practicability of such devices. This is called a walking ladder.
Six year old girls as ivell as boys climb up these poles and wcilk bij
their hands from one end to the other. As the photograph indicates,
there is hardly any limit to the kind of exercises possible ivith such
a device.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
A. J. CROWELL, M.D., President CharlotU
CYRUS THOMPSON, M.D Jacksonvllla
THOMAS E. ANDERSON, M.D Statesville
E. J. TUCKER, D.D.S Roxboro
D. A. STANTON, M.D High Point
JAMES P. STOWE, Ph.G Charlotte
JOHN B. WRIGHT, M.D Raleigh
L. E. McDANIEIj, M.D Jackson
CHARLES C. ORR, M.D. Asheville
EXECUTIVE STAFF
CHAS. O'H. L.AUGHINGHOUSE, M.D., Secretary and State Health Officer. RONALD B. WILSON, Assistant to the Secretary.
C. A. SHORE, M.D., Director State Laboratory of Hygiene.
G. M. COOPER, M.D., Director Bureau of Health Education.
H. E. MILLER, .C. E., Chief of Bureau of Engineering and Inspection.
F. M. REGISTER, M.D., Director Bureau of Vital Statistics.
H. A. TAYLOR, M.D., State Epidemiologist.
GEORGE COLLINS, M.D., Director Bureau of Maternity and Infancy.
C. N. SISK, M.D., Director of County Health Work.
ERNEST A. BRANCH, D.D.S. , Director of Oral Hygiene.
FREE HEALTH LITERATURE
The State Board of Health publishes monthly The Health Bulletin,
which will be sent free to any citizen requesting it. The Board also has
available for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested.
Adenoids and Tonsils
Cancer
Catarrh
Care of the Baby
Constipation
Colds
Clean-up Placards
Chickenpox
Diplithei-ia
Don't Spit Placards
Eyes
Flies
Fly Placards
German Measles
Hookworm Disease
Infantile Paralysis
Indigestion
Influenza
Malaria
Measles
Pellagra
Public Health Laws
Prenatal Care
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placards
Typhoid Fever
Typhoid Placards
Veneral Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY AND INFANCY
The following special literature on the subjects listed below will be
sent free to any citizen of the State on request to the State Board of
Health, Raleigh, N. C:
Prenatal Care (by Mrs. Max West)
Infant Care (by Mrs. Max West)
Prenatal Letters (series of nine
monthly letters)
Minimum Standards of Prenatal Care
What Builds Babies?
Breast Feeding
Sunlight for Babies
Save Your Baby
Hints to North Carolina Mothers Who
Want Better Babies
Table of Heights and Weiglits
The Runabouts in the House of Health
(pamphlet for children from 2 to 6
years of age)
Baby's daily Time Cards: Under 6
months; 5 to 6 months; 7, 8, and 9
months. 10, 11, and 12 months; 1
year to 19 months; 19 months to 2
years.
Diet Lists: 9 to 12 months; 12 to 15
months; 15 to 24 months; 2 to 3
years; 3 to 6 years.
CONTENTS
PAGE
Health Calendar 3
An Old Story 4
A Disappointed Child 6
International Congress On Men-tal
Hygiene 7
Asthma 8
Starving In A Land As Fertile As
the Nile IC
PAGE
Pulling At Your Heartstrings 16
Preventive Medicine As Applied To
The Individual 21
Out Of Date 23
The Venereal Menace 24
Immunization 28
The Cost of Sickness 31
How Is This For Milk Drinking.. 31
Project About Diphtheria 13 Property Against Human Life. 32
VOL. XLV FEBRUARY, 1930 NO. 2
HEALTH CALENDAR
FEBRUARY
As a rule, during nearly all the
year the climate of North Carolina
is seldom too cold in winter to pro-duce
much discomfort or suffering,
and it is infrequent that the weather
in summer is too hot for a sufficient
length of time to produce illness as
a result.
About the only month in the year
which affords any exception to the
foregoing statement might be said to
be the month of February. In most
years, although it is the shortest
month, it generally has more dis-agreeable
weather than any other
month. For most of our people, who
enjoy outdoor life, certainly to some
extent, during most of the year, the
cold, disagreeable days of February
sometime cause more indoor crowding
than any other period in the year.
This results in an undue prevalence
of the respiratory infeajtions. Peo-ple
are crowded more in the stores,
in street cars, and in their homes,
and infection therefore is more eas-ily
spread from person to person on
account of the close contacts neces-sary.
The records always result in a
rather high death rate from pneu-monia
during this month, and other
diseases of like character. It is a
month generally fraught with more
danger than usual to old people, espe-cially
those who suffer to some ex-tent
from chronic ailments, such as
bronchitis and so on. It is literally
mid-winter for the children in the
schools. Ventilation, and at the same
time a comfortable atmosphere, is a
little harder to maintain during this
month than other months, thus mak-ing
respiratorj? troubles more common
in the schools.
Another deficiency which everybody
suffers is from the scarcity of fresh
vegetables and fruits which are avail-able
in more abundance during the
other months. For those who are
financially able to avail themselves
of the abundance of fresh stuff, im-ported
from Florida and other places
in the far South, the deficiency is
not so acute, but as about half the
population of the State live on the
farms and are dependent on the prod-ucts
of their own gardens and fields
for food, the deficiency is sufficient
to result in temporary impairment of
health at least.
These handicaps may be overcome
to a certain extent by concerted ef-fort
on the part of every one respon-sible.
A little more care may be di-rected
toward the heating plants and
the ventilation of school rooms. The
same thing may be undertaken by the
householders in the homes, no matter
what kind of a heating plant there
may be, whether open fire place or
steam heat; and a satisfactory effort
may be made to procure at least some
fi-esh vegetables every day; and for
the old people a little extra care as
to food, sleeping and clothing require-ments
may help considerably in
coming through the month without
any impairment of health.
We cannot close this subject in
The Health Bulletin February, 1930
any more satisfactory manner than
to return to our old slogan, name-ly,
"A Garden for Health" for every
family in the State who can afford
it.
Doctor Henry Albert, State Health
Commissioner of Iowa, sends out the
following suggestions which he sug-gests
might reduce the liability to
pneumonia and other respiratory in-fections
to a minimum:
"1. Avoid persons who have coughs
or colds and are sneezing,
2. Avoid use of glasses and dishes
which are not properly washed.
3. Avoid visits to persons ill with
colds, influenza and pneumonia.
4. Wash your hands before eating
and after caring for the sick.
5. Dress warmly and avoid unneces-sary
exposure.
6. Do not use towels or handker-chiefs
used by others.
7. Avoid a starvation diet but do
not over-eat.
8. Sleep with the window in your
room open but be warm.
9. Keep the temperature of the
house and office at not over 70°.
10. Cover mouth and nose when
coughing or sneezing."
AN OLD STORY
In one of the weekly papers of
North Carolina which comes to our
desk we noticed the following item in
one of them in its issue of the week
preceding Christmas. Naturally we
are not giving the name of the paper,
the county, nor of the parents of the
child, because such items are con-stantly
occurring here and there in
every county in the State. So there
is no good service to be performed
by calling out the names of delin-quents
of this nature, and it would
only serve to hurt the feelings of the
parents. We would not mind hurting
the feelings of the parents if we
thought it would protect any of their
remaining children. However, if the
physician attending the sick child was
worthy of the name physician, he
has before now thoroughly impressed
upon the parents in this particular
instance the importance of protect-ing
every remaining child against
diphtheria. Following is the item:
"The many friends of Mr. and Mrs.
sympathize with them in
their sad bereavement caused by the
GAL TWO—
death of , one of their twins,
which occurred December 12th at
their home in . When little
was taken sick they supposed
it was a deep cold, but it was dis-covered
to be diphtheria. For nearly
two weeks the doctor, the parents
and friends watched and worked with
anxiety, but Thursday morning about
three o'clock she breathed her last.
They dreaded to give up any one of
their children, but it seemed to be
more sad to part the twins. She was
two years, four months and fifteen
days old."
The foregoing is a poignant story,
but it is a story that should have a
moral for every physician and health
officer and parent in this State this
coming year, and that moral is that
every child under six years of age
should be protected against diphtheria
by being given three doses, hypo-dermically,
of toxin-antitoxin, which
is the preventive vaccine against
diphtheria. All children over six years
should have the Schick test, and
if they are not immune to diphtheria,
should receive three doses, which
would be necessary to confer immun-ity.
There is no longer any excuse for
children having diphtheria in North
Carolina. It does seem that the physi-cians,
the health officers, and the par-ents,
with the help of the newspap-ers
in this State, could get this story
Fehruary, 1930 The Health Bulletin
across to all the people having small
children who need this protection.
This is the same old story that has
adorned the pages of weekly newspa-pers
of North Carolina for many,
many years. They first thought an at-tack
of diphtheria was a' 'cold," what-ever
that meant. They therefore
proceeded to rub on the neck and
chest of the helpless little victim some
dirty stinking salve, always kept in
stock in the medicine closet, or on the
mantelpiece of the poor folks, always
purchased at the drug store or gro-cery
store, and always recommended
for colds, no matter what a cold might
mean. We have no idea that the prac-tice
will cease until the millennium
is ushered in, and at that time the
children will not need the assistance.
As long as dividends must be forth-coming,
and commercial interests
mounting into millions of dollars are
concerned, there will be plenty of
salves of different kinds for sale for
the treatment of colds. Be it said to
the credit of some of these manufac-turers
that they do have at the pres-ent
time conscience enough to recom-mend
on their package, their adver-tising
matter, and on the labels of
the bottle to send for a physician in
cases of suspected diphtheria or
pneumonia. The question is, however.
How may an ignorant parent be able
to distinguish the very early signs
or dangers of diphtheria and pneu-monia?
This is especially true in the
country districts where so many chil-dren
live a long distance from the
nearest physician and where a visit
of the physician costs money, and a
lot of it. To these people it is only
human for them to trust and hope
that the application of the salve will
save the child's life.
Again the physicians have a more
important duty to perform in this
regard than any other class of peo-ple.
The State laboratory and num-erous
county laboratories are avail-able
for the examination of swarbs
taken from the throats in order to
set up a definite diagnosis within a
reasonable length of time, but, even
at that, delay in the administration
of antitoxin is dangerous. The labor-atory
report only serves to confirm
the diagnosis of diphtheria, which
the doctor may only have reason to
suspect, but the laboratory does furn-ish
almost totally free of charge a
fresh reliable product of diphtheria
antitoxin available to every physi-cian
in North Carolina. So there
is no excuse for any delay in the ad-ministration
of antitoxin.
But far more important to physi-cian
and parent, and certainly to the
children, is the fact that toxin-anti-toxin,
which is for practical purposes
a preventive vaccine, and not to be
confused with the antitoxin, which
is a serum for the cure of the dis-ease,
is available to anybody in the
State, free of charge. So it is only
necessary to have every child im-munized
against diphtheria in order
to protect from such tragedies as the
foregoing item describes as occurring
in a North Carolina county early in
December.
A -peanut ranch in the sontheastci-n
part of the State. The stacks are pea-nut
vines. It makes fine hay for cat-tle.
The Health Bulletin February, 1930
A DISSAPOINTED CHILD
Driving along a country road in
eastern North Carolina the other day
we were witness xto a little occurrence
which may happen any time, any-where,
and which, of course, in a
way, was trivial but at the same time
meant a great deal to this particular
child.
We were driving along some few
hundred yards behind a rural mail
carrier. He had stopped at two or
three boxes and we were slowly ap-proaching
him when he passed anoth-er
small residence close to the road,
but which bore every mark of neat-ness
and stood out even to the cas-ual
passer-by as an unusual little
roadside home. The carrier, not hav-ing
any mail for this particular box
at this house, naturally went on by
without stopping. Coming along be-hind
we observed a little girl, some
six or eight years of age, who was
evidently watching with great an-ticipation
for the approach of the
mail carrier. After the carrier passed
by, the child sorrowfully made her
way to the mail box, and just as we
approached, removed a beautiful
bunch of fall flowers from the box
which she had intended for the car-rier.
The look of disappointment on the
child's face and her very attitude
caused us to involuntarily stop our
car and make the acquaintance of the
little girl. We found that the child's
baby brother had been ill for quite a
while and the carrier's services had
been requisitioned quite a number of
times to bring medicines and so on
from town. The family were tenant
farmers, living on a big farm belong-ing
to an absentee landowner. The
mother had been ill previously in the
summer, the prospects for a crop re-turn
were poor, the September storm
had greatly damaged the cotton and
ruined some of the later tobacco
which had got wet, and altogether the
While February may not he a good
month to take an outdoor sun-hath
like this Riitherfordton bahy is do-ing,
it is a good time to try to get
any hahy to practice this kind of ex-ercise.
The pose is most unusual and
indicates a hahy of splendid health
and strong vitality.
outlook was gloomy for the family
the coming winter. The father's
health was none too good, and the
crop was fairly heavily mortgaged
for fertilizer and supplies typical of
the condition of so many tenant farm-ers
throughout that particular sec-tion.
The little girl reluctantly con-fided
that the mail carrier had been
so good, and that they were unable
to repay his kindness, that she
thought that as the hollyhocks and
the half dozen or so of late dahlias,
that the mother had put out in the
yard early in the spring, looked so
beautiful that she just knew the mail
February, 1930 The Health Bulletin
carrier would appreciate a bouquet to
carry to his own family, which could
be accepted as part pay for his kind-ness.
Naturally the mail carrier was in
blissful ignorance of any such inten-tion
and cheerfully drove on, probably
congratulating himself that he could
pass one box without shifting his
gears and stopping, and therefore
getting back home just that many
seconds earlier. There could have
been no doubt but that if he had
known the surprise for him in the
mail box that morning that he would
have been only too glad to have stop-ped,
and there would have been a fine
visit all around.
To us, or as it would have been to
any other observing traveler, it was
only an incidence of the day's rou-tine;
but the lesson it carries may be
applied by any reader to suit his or
her own philosophy of life as it exists
INTERNATIONAL CONGRESS ON MENTAL HYGIENE
First in the World to Be Held at Washington, May 5 to 10, 1930
On the above mentioned date there
will be held in Washington, D. C,
one of the most important interna-tional
meetings to be held in the world
during 1930. It has only been twenty-two
years since Clifford W. Beers,
who is the Secretary-General of this
first great International Congress on
Mental Hygiene, organized at New
Haven, Connecticut, the first Mental
Hygiene Society in the world. Mr.
Beers some months later, early in
1909, organized the National Com-mittee
for Mental Hygiene.
Many of our readers will recall that
Mr. Beers is the author of one of
the most celebrated books ever pub-lished.
The title of the book is "A
Mind That Found Itself." This book
has been run through more than fif-teen
editions in the last twenty
years. It is the most vivid example
of constructive criticism the world
has seen since the Sermon on the
Mount. "During the twenty years
that have since passed the peoples
of the world have become increasing-ly
conscious of the fundamental im-portance
of mental health and of the
fact that mental health, like physical
health, may be preserved and enhanc-ed
by the giving of attention to
known procedures of prevention, cure
and treatment."
About twenty countries of the world
will send delegates to this meeting,
including such representative na-tions
as England, Germany, France,
Japan, and others. The range of top-ics
to be discussed at this significant
meeting are as wide as the field of
human relations. The topics will
range all the way from such subjects
as the "magnitude of the mental hy-giene
problem as a health problem"
to such topics as "possibilities in the
future of human rerlationships in the
light of an increasing knowledge of
those factors that help and hinder
the emotional, physical and intellec-tual
development of the individual."
This meeting is sponsored by such
people as the President of the United
States, the Surgeon General of the
United States Public Health Service,
the Commissioner of the United
States Bureau of Education, Har-vard,
Yale, and Johns Hopkins Uni-versities,
the United States Depart-ment
of Interior, and many other in-stitutions
and organizations, includ-ing
a number of state boards of
health.
In the preliminary announcement
concerning the meeting the following
significant statement to public health
officers everywhere is made:
"Public Health Does, and Must, In.
elude Mental Health. The public can-not
be truly healthy unless and until
8 The Health Bulletin February, 1930
mental health and its conservation
are given deserved attention by pub-lic
health authorities, private health
agencies, medical practitioners and
private citizens. Man is more than a
physical organism. Good Health in-cludes
good mental and emotional
habits no less than good digestion,
sound teeth and healthy lungs. The
partly figurative, partly matter-of-fact,
popular slogan: 'Public Health
Is Purchasable,' applies to mental
health no less than to physical
health."
In conclusion, as an additional il-lustration
of the importance of the
meeting, it has been announced that
the transactions will be published in
full in English, French, and German,
the official languages of the Con-gress.
Membership in this association
may be had for five dollars, which
will entitle the holder to a copy of
the proceedings. Further information
may be had by writing Mr. John R.
Shillady, Administrative Secretary,
370 Seventh Avenue, New York.
ASTHMA
It is seldom that a day passes but
what some person writes to the State
Board of Health requesting informa-tion
on the subject of asthma. Not
long ago a writer in one of the larger
cities of eastern North Carolina
wrote a letter making the usual re-quest
and included some advertising
matter sent out by a concern in New
York state, which had free trial
methods and so on, as they put it,
for the control of asthma. As the
questions of this writer included
most of the questions usually asked
with reference to this subject, we are
herewith quoting some of them to-gether
with the substance of the
reply of the Editor of the Bulletin.
Following are some of the questions:
"Please advise me how I may be
relieved, or preferably cured, of
asthma. I have been troubled with
it seriously for the past two years.
I have been treated by a physician,
but I do not get much relief. I seem
to be getting worse as time goes on.
The attacks are so severe that at
times I have to stay in bed for two
or three days. After the attacks I
am so weak frequently that I cannot
get out of bed. Some people tell me
that a change of climate will cure it
others tell me that a change of cli-mate
will only give temporary relief.
Should a change of climate in your
estimation be advisable, please tell
me what place or locality you v/ould
recommend. Do you think I could ex-pect
to be cured or only get tempo-rary
relief?"
The following embraces the sub-stance
of the answer to the foregoing
request:
People generally associate the
disease called asthma with various
conditions which physicians term as
asthmatic. The two terms naturally
indicate different conditions. A per-son
may be asthmatic from many
different causes. The term asthma
ought to be limited to the specific
disease itself, which is a periodic at-tack
of bronchial spasm. There are
such variations as cardiac asthma,
caused by disease of the heart; renal
asthma, relating to kidney diseases;
and so on.
True asthma is sometimes due to
ear, nose, or throat troubles, or
chronic bronchitis. It frequently oc-curs
with acute irritation of the mem-branes
of the upper respiratory tract.
This is the case when it is caused by
irritation from pollen or dust parti-cles
or drug irritants. Genuine as-thma
gives more trouble to the pati-ent
suffering from it at night than
it does any other time. Sometimes
the suffering continues all night, and
occasionally an attack will last sever-
Fehruary, 1930 The Health Bulletin
al days, giving trouble day and night.
Such is the case not infrequently in
spite of all efforts at medical treat-ment.
Even though the attack be
controlled with powerful drugs, in
such cases it recurs when

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JOSEPH RUZICKA
BOOxetMOERS
BALTIMORE.MO
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be taken from the
Library building.
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JUL 1 5 ]%]
LUNC-15M N.36
OP-13370
Putlislyed h^ TAZ. N°KJI\ (M9Lm^ 5TATL D°ARD s^AE^LTA
This BulkliAwillbe -serxt free to qu\3 ci"tizer\ of Ihe State upor\ request.!
Entered as second-class matter at postoffice at Raleigh, N. C, under Act of July 16,
1S94. Published monthly at the office of the Secretary of the Board, Raleigh N. C.
VOL. XLV JANUARY, 1930 NO. 1
The midwife class of Person County. These women have been taking a
course of instruction provided by the county health department, spo7isored by
Miss Ruth McCollum, the county nurse. It is a creditable looking group. They
are putting into effect the practical idea of improving the status of all mid-wives
as long as there remains a single woman needing their services.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OP HEALTH
A. J. CROWELL, CTRUS M.D., President r>>,o^i^«.» THOMPSON, M.D._ tV.v^ ^m* THOMAS E. ANDERSON, M-DTI: «^t^f°°yH '
E. J. TUCKER, D.D.S._. I
Statesville
D. A. STANTON, M.D._r___ ' £rV u ?. •
°
JAMES P. STOWE, Ph.G. ^^Mu ^^i?* JOHN B. WRIGHT, M.D Charlotte
L. E. McDANIEL, M.D. __ Raleigh
CHARLES C. ORR, M.D. 1- i"^t*^^?," Asneville
EXECUTIVE STAFF
ROnIld^ ^V^olEf^a^^^.^^; }^-^i:
KONALDB. WILSON Secretary and State Health Officer. Assistant to the Secretary.
?< V; ^M93^ M.D., Director State Laboratory of Hyeiene
H E- M?TI'^' ^^' ?i5*?'°^ g^^^*^ «' Health Educatfon.
F m" REmf^R Mh^^A^^ "t
Bureau of Engineering and Inspection.
H A TAVTHT?^^ •i*-°/'^^^^°?'.B".^^,^^ °^ V"^l Statistics. t±. A. iAYLOR, M.D., State Epidemiologist.
^^g^Qf COLLINS M.D Director Bureau of Maternity and Infancy.
iErR;>NTfEvS^^TriSK, M.D., Director of County Health Work A. BRANCH, D.D.S., Director of Oral Hygiene.
FREE HEALTH LITERATURE
whi-Jw^-lfhl^ ^^^'^ of Health publishes monthly The Health Bulletin,
T^LSkT l^i-^r^-^""!? *° ^"7 "^'^^^ requesting it. The Board also has available for distribution without charge special literature on the follow-ing
subjects. Ask for any in which you may be interested
Adenoids and Tonsils
Cancer
Catarrh
Care of the Baby
Constipation
Colds
Clean-up Placards
Chickenpox
Diphtheria
Don't Spit Placards
Eyes
Plies
Fly Placards
German Measles
Hookworm Disease
Infantile Paralysis
Indigestion
. Influenza
Malaria
Measles
Pellagra
Public Health Laws
Prenatal Care
Sanitary Privies
Scarlet Fever
Smallpox
Teeth
Tuberculosis
Tuberculosis Placards
Typhoid Fever
Typhoid Placards
Veneral Diseases
Water Supplies
Whooping Cough
SPECIAL LITERATURE ON MATERNITY AND INFANCY
.pnt'^f!^!/t"'''^'"^-'.?^"^^^'tf^i"'"^ °" ^^^ subjects listed below will be
Health, RaleighfNlc.?
^^^^ °'' ''^"''* *° ^^" ^^^^^ ^°^^d °f
Prenatal Care (by Mrs. Max West)
Infant Care (by Mrs. Max West)
Prenatal Letters (series of nine
monthly letters)
Minimum Standards of Prenatal Care What Builds Babies?
Breast Feeding
Sunlight for Babies
Save Your Baby
Hints to North Carolina Mothers Who Want Better Babies
Table of Heights and Welgiits
The Runabouts in the House of Health
(pamphlet for children from 2 to 6 years of age)
Baby's daily Time Cards: Under 5 months; 5 to 6 months; 7, 8, and 9 months. 10, 11, and 12 months; 1 year to 19 months; 19 months to 2
years.
Diet Lists: 9 to 12 months; 12 to IS months; 15 to 24 months; 2 to 3
years; 3 to 6 years.
CONTENTS
PAGE
North Carolina Health Prospects
For 1930 ^^____ 3
Practical Health Teaching' In Wilk-inson
School 4
Recalls Days of Embalmed Beef and
Typhoid Fever 6 Vitamin Band Pellagra 7 Preventing Unnecessary Noises—1__ 8 Heart Disease and the Public Health 9 Who Is Educated? 10 Practice of Medicine Regarded as
Public Utility 11
PAGE
Driving On Left Side of Road 13 Broken Wings 14
Vaccination Pacts 21
College Blues 23 Our Lives Shorter, Not Longer 25
Common Sense and the Open Win-dow^
26
Dosers 28
Our Back Cover Cartoon 29 How Very Few of Us Die 30 An Encouragement 31
VOL. XLV JANUARY, 1930 NO. 1
NORTH CAROLINA HEALTH PROSPECTUS FOR 1930
Facing a new year is an adventure
for everj" living human being from the
infant in its crib to the individual
who has marked off three score and
ten years. For many of the infants,
too many of them, the journey will
be perilous. For many of the aged it
will mean embarkation on the "Third
Puzzle" of human existence. Accidents
and untimely deaths, most of which
are preventable, will take heavy toll
among the intervening ages. The same
history is recorded year after year.
It is the business of a health depart-ment
to make the traveling of the in-fants
less hazardous, to reduce the
preventable toll taken from those of
active age, and to defer the em-barkation
of those of advanced years
as long as possible.
The practical question is, how may
these things be done? The equally
practical answer is, by efficiencj',
honesty and industry on the part of
health department personnel, county,
city, and state, in vigorously teaching
the people how to apply the scientific
principles of disease and accident pre-vention.
We herewith set forth some of the
things that might be done.
Every prospective bride and groom
might be taught the dangers of ve-nereal
disease with the disastrous
consequences which so often follow
such infection. Every prospective
mother should receive expert care and
adx-ice during the entire pre-natal
period. She should have the proper
kind of food in adequate quantity. Any
abnormal condition manifesting itself
should have immediate medical at-tention.
During the birth process ev-ery
needful attention should be avail-able.
Thus the maternal dangers may
be largely eliminated. The infant then,
given a healthy heritage free from
venereal infection, may have at least
an even start. Every infant born
should have right from its first hour
the inalienable right of nourishment
from its mother's breast, unless a com-petent
physician certifies that breast
feeding would be dangerous for the
mother and disastrous for the infant.
Soap is cheap and water, fresh air and
sunlight in North Carolina is practic-ally
unlimited the year round. The
baby should, therefore, have a clean
bed, regardless of rags or poverty
(the rags can be clean ones), mother's
milk, sunlight and clean air. The male
relative with pipe or cigar, or the
mother with cigarette, should be equal-ly
barred from the baby's presence as
the visitor with a cold. Give the baby
air free from the germs of respira-tory
infection, the irritating effects of
nicotine loaded smoke, good breast
milk, a clean bed, good heritage from
healthy parents, let it alone and the
chances are better than even the baby
will do the rest for the first eight or
nine months of life. Careful attention
to the establishment of health habits
with assurance of right kind of food,
frequent inspection by the family phy-sician
and dentist will take care of the
pre-school period and ensure the pre-sentation
of a healthy young animal to
the school at the ripe and experienced
age of six. These first six years are
the important ones. Then is the pe-riod
when the parents should know
The Health Bulletin January, 1930
the water is pure, the milk safe and
the food of the right kind, adequate
and properly prepared. Two of the
most important things to do during
the first year is to see that the infant
is successfully vaccinated against
smallpox and that it has three ade-quate
doses of a fresh product of
toxin-antitoxin properly administered
to guarantee against diphtheria.
Measles, whooping cough, and scarlet
fever should be guarded against with
all possible care. Six years old and
healthy when school troubles begin
means power to win if the teacher is
intelligent. There are so many aids to
good health now available for the
school children almost all over the
State, that no pupil's health should be
jeopardized during these years. Never-theless
many thousands of them have
their health seriously impaired in
many ways which could be avoided.
But we may take heart here for the
teachers are learning. It is the solemn
duty of every health officer to help
teach them, and none the less the ob-ligation
of every practicing physician
to do the same thing. Shorter school
hours for younger children, all those
under twelve, and rigid supervision of
school cafeterias may be regarded as
the two most imperative demands for
better health safeguards for school
children. It ought not to be necessary
to say that if any child is so unfor-tunate
as to be admitted to school this
year before receiving a successful vac-cination
against smallpox and diph-theria
this important deficiency should
be remedied during the first thirty
days of school.
In all the foregoing the one respon-sible
individual who is paid a salary
from public moneys to do these things
is the local health officer. It makes no
difference whether he is a full time
official or a part time one, the obliga-tion
is equally binding. It is no use
to say the fault is the parents, or the
practicing physician's when failure to
invoke protection is present. The
health officer must secure the coopera-tion
of parent and family physician.
Details and methods by which things
may be done are unimportant. Getting
them done is the important point.
Plans and programs should be made
to fit the local needs. But the prin-ciples
are fundamental and State-wide.
For the general population atten-tion
should be given to a more plenti-ful
supply of fruits and vegetables
and an increase in the consumption of
dairy products, poultry, eggs, meat,
and fish, by people who need to guard
against the deficiency diseases. Pure
water, whether it be for village or city
dweller or on the farms, should be
made available. Better safeguards to
assure clean and safe milk. Adequate
screening of all houses, the extension
of sewage facilities and sanitary
privies where needed are among some
of the things to be looked after in our
1930 health prospectus.
More humane and sympathetic care
for the aged and the "down and out;"
the better safeguarding of the health
of working people in all kinds of in-dustry
and agriculture are among our
biggest needs. For the adult individual
a health examination, a really truly
health examination, not a pulse feeling
and tongue inspecting enterprise,
would if included in the year's pro-gram
add much to the happiness of
all such wise folk as well as possibly
adding a little something to the span
of life.
May your New Year be what you
try to make it.
PRACTICAL HEALTH TEACHING IN THE
WILKINSON SCHOOL OF ROCKY MOUNT
Early in October the teachers of the
Wilkinson school of Rocky Mount,
North Carolina, wrote to the State
Board of Health explaining a plan
they had for the practical teaching
of health matters in the school this
January, 1930 The Health Bulletin
year. They informed us that they had
about three hundred and twenty-five
pupils in this particular school.
The plan that they proposed to put
into effect is one that any wide-awake
school of the State can also utilize.
Briefly speaking, they propose to take
up one phase of health teaching each
month and study that exhaustively.
They selected as their subject for the
month of October the care of the teeth.
They asked us to supply them with
literature in the form of a short
pamphlet on the care of the teeth,
sufficient to supply each one of the
pupils with a copy. It so happened
that we have been distributing for ten
years all throughout North Carolina a
carefully written special pamphlet on
the care of the teeth. This little
pamphlet has two cuts, one a drawing
of the temporary teeth and one that
of the permanent teeth. The two are
placed on the same page. Each tooth
of each set has the proper name and
the approximate date of eruption.
The teachers of the Rocky Mount
school proceeded to examine each child,
writing his or her name on the pam-phlet
to begin with. Whenever they
found a child who had a particular
tooth corresponding to the tooth on
the plate, either temporary or perman-ent,
which was decayed, they mark-ed
this particular tooth "decayed" or
"needed dental attention." Each child
was then asked to take this pamphlet
home and to show the parents the sit-uation
that the teacher had found.
This is certainly beginning at the
beginning and is one of the most ef-fective
methods of teaching practical
care of the teeth we have ever seen.
The method assures concentrated in-terest
on the part of the parent at a
time when it will probably do more
good than it could ever do again. The
information carried in the pamphlet
is sufficient to explain to the parent
the importance of taking action imme-diately.
No dentist in the world could
criticise this procedure. The examina-tion
was not a dental examination, and
if a tooth had a decay in it big enough
for a teacher to see, it is a self-evident
proposition that the dental services
were needed; and, after all, the re-sponsibility
of health departments and
teachers is to get children who need
dental or medical care into the hands
of capable dentists and physicians.
This procedure on the part of the
Rocky Mount teachers strikes us as
being the finest method yet devised
to do that particular thing.
To go a little farther along with
the Rocky Mount program, another
month, after they settle the teeth
question, is to be devoted to the ques-tion
of a study of the prevalence, dan-gers,
and prevention of diphtheria.
Here again we are able to provide
them with literature which is to the
point, sufficient for each child and its
parents to have. In this way every
parent who is patronizing the Wilkin-son
school in Rocky Mount will have
directly called to his attention the fact
that diphtheria may be easily pre-vented
through the administration of
toxin-antitoxin to any young children
in their families. If the parents do
their part and act on the suggestions
which will be brought directly to them,
there should not be a single case of
diphtheria developing m the Wilkinson
school of Rocky Mount when the fall
session of 1930 opens. This will give
ample time for the immunization
thi'ough the winter and spring of any
children in homes patronizing that
school for the immunization to take
full effect before the school opens next
September.
And another item of vast import-ance
to the health of the school chil-dren
is the question of foods. The
teachers propose to take one month for
the study of the particular kind of
food, the quantities, and so on that
school children should have. These are
only items illustrative of the fine and
comprehensive program these teachers
are carrying through.
We take pleasure in departing from
our usual custom in which we are
The Health Bulletin January, 1930
treating all matters these days dis-cussed
in the Bulletin in an imperson-al
manner, by mentioning the names
of the two teachers who have initiat-ed
this program. Communication to
the State Board of Health was made
by Miss Charlie Westbrook, one of the
teachers in the Wilkinson school, and
Miss Bessie McDearman, principal of
that school. We hope that other teach-ers,
when engaged in their schools, will
follow the example of these wide-awake
teachers in this particular
Rocky Mount school. The field is un-limited
and the need is great for just
such practical teaching.
RECALLS THE DAYS OF EMBALMED BEEF AND
TYPHOID FEVER
Thirty-two years ago this month the
battleship Maine was blown up in Ha-vanna
Harbor, and very soon there-after
the country was at war with
Spain. Some few weeks ago the Mon-roe
Journal published a rather poig-nant
little story from a Monroe citi-zen
who is a veteran of that war. The
story recalls to mind so graphically
the conditions in this country, and in
the army where typhoid fever killed
many more soldiers than Spanish bul-lets,
that we herewith publish it in
full. To a present-day health officer
in North Carolina it will read like a
story from some ancient and musty
history. However, there are many of
us who can remember only too well
the conditions that existed in the civil-ian
population in North Carolina just
as well as obtained in the army.
This man speaks from personal
knowledge. He was a victim. The story
has gone the round many times of a
pompous major general of one of the
camps walking up and tearing from
a polluted well a notice from the med-ical
department warning the soldiers
not to drink the water from that par-ticular
well. This old incarnation of
political authority, and ignorant of
things outside of his particular tech-nical
training, proceeded to drink of
the water and to remark that all this
medical palaver was foolishness. At
the time hundreds of his soldiers were
sick from typhoid fever, and many of
them were dying every day. We have
certainly traveled some distance since
that day. Read the story that this sol-dier
tells, and take heart that in some
things the world is not as bad as it
was thirty-two years ago.
"When Mr. John Holloway put on
his uniform of a soldier of the Span-ish-
American War, people said, "Hel-lo,
Mr. Holloway, I didn't know you
were a Boy Scout.'
"That riled John, riled him to think
that the war in which he had been a
soldier and came very near losing his
life, could be totally forgotten by the
older people and wholly unknown to
the young.
"But that is about the truth of it.
And the government takes the same
attitude, says Mr. Holloway. It does
just about half as much for a veteran
of the Spanish-American War as it
does for one of the World War for
exactly the same disability. And
though it paid him only fifteen dollars
and sixty cents for soldiering, it mus-tered
him out without any compensa-tion
adjustment at all.
"Dewey captured the Spanish fleet
in Manila bay on May first, 1898, and
Schley smacked the Cevera fleet on
July fourth. At that time the Ameri-can
soldiers, every last one of them
volunteers, were being prepared to
land in Cuba, but a lot of them never
got there. They were already dead or
dying of typhoid fever or starving on
embalmed beef in the concentration
camps. John Holloway was one who
was laid up with typhoid fever and his
leg was swollen as big as his body
when his regiment embarked for Cuba.
"There are a good many more Span-ish-
American War veterans around
here and there and no doubt they feel
January, 1930 The Health Bulletin
about like John of the hardships of
that war and the scant attention they
now receive, especially as John says,
since what they underwent caused the
revolution that swept away the men-ace
of embalmed beef, cheating con-tractors
and such like and started the
war against typhoid and made army
camps at last free from such dis-eases."
VITAMIN B AND PELLAGRA
In a letter to the Editor of the Bul-letin
sometime ago a physician friend
remarked that he could not see why
pellagra should be regarded as a de-ficiency
disease in view of the fact that
the pellagra preventing principle in
food known as vitamin B is the most
widely disti'ibuted vitamin in nature,
and so that practically the diet served
on all tables in the homes of the peo-ple
of this State therefore had an
abundance of vitamin B, and that they
could not help eating a considerable
amount of food containing this vita-min.
The fact that vitamin B is present
in the leafy vegetables such as let-tuce,
cabbage, spinach, turnips, in liv-er,
kidneys, tomatoes, beans, peas, po-tatoes,
eggs, milk, in addition to the
large amount found in yeast and the
basic foods of every family, cereals,
would seem to afford a sufficiency of
this necessary element. It is, of course,
true that an abundance of this vitamin
is available, provided we eat it.
We have just called cereals the basic
food of every family. This is true, be-cause,
in North Carolina at least, corn
bread, white store bread, or biscuit
made from white flour, composes the
bread diet for ninety-nine per cent or
more of the people. In a thorough-go-ing
study of this point the late Dr.
Edward J. Wood made a special trip
to some of the large flour mills in the
Central West in order to see the pro-cess
employed in making flour, a large
quantity of which was shipped and is
shipped to this State for consump-tion.
He made the same investigation
concerning the manufacture of the
commercial corn meal handled in large
quantities by the grocery stores of this
section also. He learned that the germ
of the wheat, and of the corn, was
removed in the milling process, be-cause
this portion of the grain, which
contains the vitamin B, if retained,
then the flour or the corn meal was
many times more subject to mold and
spoilation in shipping, and therefore to
commercial loss.
People who eat the native whole
wheat bread from wheat made in this
section, or at least milled in this sec-tion,
and which contains all of the
This little Youngaville girl weighed
only two pounds when one ivcck old.
She lay on a pillotv in a bassinet with
hot water bottles around her for the
first three months. During this time
she teas fed lactic acid milk sweetened
ivith corn syrup, and administered
with a medicine dropper. She is a fine
example of what may be done with
patient and intelligent care, includ-ing
parental, nurse and medical.
8 The Health Bulletin January, 1930
wheat kei-nel, including the germ, get
the vitamin B in proper proportion.
In the same way the many thousand
families in the State who embrace the
opportunity of getting their corn meal,
from which they make their corn
bread, from local grist mills, especial-ly
from local mills in which the North
Carolina corn is utilized fresh from
the barns and fields of the local farm-ers,
also get vitamin B in their corn
bread, although in smaller proportions
than in the whole wheat bread. Dr.
Wood therefore held that the basic
cause which made pellagra possible
was that the people who had been de-pending
upon a diet rich in the gei-ms
of wheat and corn in their bread,
when deprived of this through the
commercial products utilized in recent
years, failed to get enough of the pel-lagra
preventing principles by eating
it in other foods, sufficient to make
up for the deficiency.
We reiterate here the doctrine of
Goldberger and Wood, that it is not
only necessary to have an adequate
diet on the table containing an abund-ance
of vitamin B, called by Goldberg-er
the pellagra preventing principle,
but it is essential that this diet be
consumed by the person who would
avoid pellagra or other deficiency dis-eases
of like character.
PREVENTING UNNECESSARY NOISES
Some of the health departments in
the various cities of the country are
very much concerned over the ques-tion
of control of unnecessary noise.
The city of London has had various
commissions at work making surveys
in their thorough-going style as a pre-liminary
to city ordinances drastical-ly
extending control in order to pre-vent
these nuisances. In this State the
city of Greensboro raises a big fuss
about the blowing of train whistles
and the exhaust racket kept up dur-ing
the night by a surplus of motor
cycles. In some of the cities of the
North street cars are blamed for a
great deal of the noise, the city of
Dayton, Ohio, in its Health Bulletin
declaring that there had been no im-provement
from a noise standpoint in
the operation of street cars of that
city in a third of a century.
Nearly all the cities and towns in
our State find the unnecessary blow-ing
of automobile horns nothing short
of an unmitigated nuisance. The vi-bration
caused by heavily loaded
trucks running at rapid speed on the
streets at all hours of the night is
another cause for complaint. For the
most part the latter are engaged in
the work necessary to be done for the
welfare of the people, and nothing we
know could be done to prevent it ex-cept
better training of the drivers as
to how to reduce the racket to a min- I
imum. In the case of blowing automo-bile
horns, in our opinion about one
toot every six months for the average
car is sufficient. The fact is that the
manufacturers ought to be prohibited
by law from equipping cars with
horns. If this nuisance were drastical-ly
abated in the foregoing manner,
and an ordinance strictly enforced, re-quiring
all drivers to keep well to the
right side of the road, there would not
be any possible excuse for a horn on
an automobile. Some critic might prob-ably
say that it would still be neces-sary
to warn pedestrians, but the fact
is that a few sharp blasts from the
automobile horn when a pedestrian is
crossing the street only tends to con-fuse
him and make bad matters worse.
The pedestrian, of course, must be
taught to look before he crosses the
street, just as the automobile driver
should be trained to stay on his side
of the road. The ringing of the train
bells and the blowing of locomotive
whistles day and night in thickly
populated resident portions of town
certainly should be reduced in volume
|
and used only as a necessity in the
safe operation of trains. For the rath-
January, 1930 The Health Bulletin
er large volume of sound as an inci-dent
of making general "whoopee" in
the residential sections of towns in all
hours of the night, that is a matter
for education and regulation by com-petent
authorities.
HEART DISEASE AND THE PUBLIC HEALTH
It was not until about the beginning
of the present century that tubercu-losis
was definitely recognized as a
public health responsibility. Only re-cently
cancer has been placed in the
category of diseases constituting a
public health problem. The fact is that
it is not even so recognized every-where
now. The extremely communic-able
diseases like smallpox have natur-ally
been looked upon as public health
problems all the time. We are glad to
he able to record the fact that now
heart disease is coming to be looked
upon as just as definitely a public
health problem as cancer is.
Progress tov/ard the control of the
spread of tuberculosis is much more
satisfactory now that it is realized
that the disease is almost always con-tracted
in childhood through exposure
of infants and very small children to
contamination with the fresh sputum
and other discharges coming from tu-berculous
patients living in close con-tact
with the infants. When it was
learned that this infection was pres-ent
in latent form in the children, to
become manifest in later years, then
it was that the most intelligent efforts
could be directed against the eradica-tion
of the disease.
It is now realized that about seven-ty-
five per cent of all cases of heart
disease develop in children ten years
of age or under, and that only about
ten or twelve per cent develop in per-sons
over forty years of age. Heart
disease is one of the gi-eat killers of
this country. More than twice as many
people die each year from heart dis-ease
as do from kidney disease or from
cancer or from pneumonia; and these
four diseases constitute the four chief
causes of death.
Another disturbing element is that
the rate of death from heart disease
is increasing about twice as rapidly as
the rate of population increase. Often
heart disease is congenital; that is, a
child is born with the disease present,
and in such cases nothing can be done
to prevent its development and the
probable early death of the child. The
only thing in such possible cases that
can be done is to pay more practical
attention to the care necessary to safe-guard
expectant mothers. The other
form of heart disease; that is, the
form that is acquired after the healthy
birth of a baby, is nearly always due
to complications resulting from com-municable
disease, or to improper hab-its
of living.
The group of diseases known under
the general term as rheumatism is
notably large. Rheumatism is at this
time believed to be a germ disease.
For many years the doctors and den-tists
have had a great deal to say
about focal infections. In these condi-tions
so-called rheumatism infection
is frequently a result of diseased ton-sils
or decayed teeth, the germ gain-ing
entrance into the blood stream
through such conditions in the body.
The chief thing to emphasize in this
connection is that the best method of
prevention of such conditions is to pre-vent,
when possible, decayed teeth,
and also to preserve, if possible, norm-al
tonsils, through care for the gen-eral
health of the child before and
after birth, the prenatal care, of
course, directed to proper hygienic
living, proper food, and the freedom
from disease of the mother.
The United States Public Health
Service in a recent publication stated
the tabulations of physical records of
five thousand school children under
their supervision showed that of the
children whose tonsils had been remov-ed
for serious tonsillar infection in
10 The Health Bulletin January, 19SO
A fine pair of Jackson County twins.
At present both are underweight, but
we hope that handicap will be re-moved
at an early date.
the past, twenty out of every hundred
had attacks of rheumatism, and of
the children with defective tonsils
which had not been removed, seven-teen
out of every hundred had rheum-atism.
With the former group, four
had heart disease, and of the latter
group, three out of each hundred had
heart disease. The showing, however,
for children who had normal tonsils
which had not been removed and
which were not diseased was much
better, not more than one-third as
many having indications of heart dis-ease.
The use of the word "rheumatism"
is somewhat misleading, because of
the fact that in the past so many
poorly classified conditions have been
diagnosed as rheumatism. This has
been done to the point where the
average intelligent physician feels
that when the word "rheumatism" is
used, it is done so as a general term,
and means very nearly nothing. Much
experimental research work remains
to be done in this group of diseases
before an intelligent classification can
be made. It is sufficient for our needs
in this discussion, however, to recog-nize
the fact that heart disease is an
increasing menace, and that it results
from many communicable diseases as
well as from improper habits of liv-ing.
In conclusion, we would like to em-phasize
again the fact that to do any-thing
much with heart disease requires
an early beginning, and it is one con-dition
in which prevention is about
the only logical procedure toward
which all efforts at eradication should
be directed.
WHO IS EDUCATED?
September and October this year
have been disappointing to the State
Board of Health officials and to the
public health workers in general in
North Carolina because of the fact
that the presence of diphtheria, judg-ing
from cases reported throughout
the State, has been just as serious, if
not more so, than in previous years.
We have said it several times be-fore
orally and in print that there is
today in North Carolina no excuse for
a parent whose child has diphtheria.
The reason for this statement is that
toxin-anti-toxin properly administered
to young children affords such a max-imum
of protection that it is exceed-ingly
rare for any child to have diph-theria
after immunity is secured
through the administration of toxin
antitoxin.
A short time ago a close personal
friend of the writer, a university grad-uate
and an important North Carolina
educator, was detained at his home on
account of an attack of diphtheria in
his youngest child, a boy of six years
of age. The child had started to school
at the opening of schools in Septem-ber.
Naturally being exposed, as so
many other thousands of children are
every fall, for the first time to diph-
p
January, 1930 The Health Bulletin 11
theria and other contagious diseases,
not having had the protection afforded
by toxin-antitoxin, and being suscep-tible
to the disease, he promptly con-tracted
diphtheria. The wife of this
friend is an educated woman. Both of
them have had access to the litera-ture
and other channels of informa-tion
concerning every protective de-vice
available for the rearing of their
children. Their home is located within
four blocks of one of the four oldest
whole-time health departments in
North Carolina. The health officer in
that county has been giving toxin-antitoxin
at frequent intervals to the
children of all parents who would take
the trouble to bring them to the office
or arrange the schedule in the differ-ent
sections of that particular county.
The same thing has been done in many
other counties, and yet there are lit-erally
thousands on thousands of chil-dren
in North Carolina today who
have not been given this protection by
their parents. Our friends in response
to the question as to why they had
neglected to protect their child
through toxin-antitoxin last spring
and summer, knowing that their child
would start to school this fall and be
exposed to diphtheria, replied that
they just simply had not done it. They
were not indifferent to the value. They
were not in ignorance of its protection,
but they simply had not got around to
it.
A few days later we were in the of-fice
of the health officer of Randolph
County just preceeding a county-wide
teachers' meeting in which the super-intendent
of Randolph County schools
was making a particular point to em-phasize
the importance of public
health protection at his very first
county-wide teachers meeting held in
the county. While we were sitting in
the office conversing with the health
officer, a nearby farmer came in with
his two children, a little boy of four
and a baby of fifteen months. They
had been there for their first dose a
week previous, and on entering the
office the little four year old began
pulling up his sleeve, and, with a
broad grin on his face, told the health
officer he was "ready for another one."
In less than a half minute the health
officer had administered the second
dose of toxin-antitoxin to the fine little
chap. There was just about as much
pain as a mosquito bite, and if the
reaction is no worse than the average,
that was the last that the little fel-low
would hear from that dose.
Now our question is, so far as pub-lic
health protection goes. Whose edu-cation
in these cases proved to be the
most practical?
PRACTICE OF MEDICINE NOW REGARDED AS A
PUBLIC UTILITY
Doctor Henry G. Longworthy is the
treasurer of an organization known
as the Inter- State Post Graduate Med-ical
Association of North America. He
wrote an article which was published
in the September issue of the Nation's
Business Magazine. He begins his ar-ticle
with the astounding statement
that "The practice of medicine today
may be regarded as a vital public util-ity
function well regulated by law and
well managed by physicians, hospit-als
and social agencies."
He pictures the physician of the
present day who practices medicine in
the city as a "bedside medical engi-neer."
He says that as a medical ex-ecutive
such a physician "engineers or
calls to his aid at the bedside for the
benefit of the patient, all necessary
consultations, hospital facilities, nurs-ing,
diet, and all the other sciences.
In many cases for the diagnosis and
treatment of a single patient, this
medical executive will use the services,
directly or indirectly, of a dozen to a
hundred persons."
The foregoing is true and it is what
12 The Health Bulletin January, 1930
is making the practice of medicine to-day
one of the most complicated and
costly of professions. It accounts for
the enormous cost of hospital care.
The sinister phase of it is that the
successful physician can no more hope
or expect to get back to old style
economic individualistic methods than
he can expect or desire to return to
his saddle bags and home-made pills.
The danger in the situation lies in the
possibility of the physician (medical
engineer) becoming of necessity a sim-ple
cog in a vast machine whose final
superior may be a political cabinet of-ficer.
That is the spectre of State
Medicine so many thoughtful physic-ians
fear. In such an arrangement the
individual patient would receive about
as much personal and individual at-tention
as one biddie in an incubator
flock of ten thousand.
This is the day of big business. All
of us think and talk in terms of bil-lions,
whether it be debts or folks.
Mergers and combines are in complete
and glorious control of everything. The
pendulum has simply followed the
law of averages and swung back from
the period of thirty years ago when
no corporation or combine was too
small or too poor to be kicked. What
more natural then, in the present
mental state, than to regard the doc-tor
along with the chain store opera-tor
as a purveyor of a public utility
because he has something to sell that
most people have to have at one time
or another.
The writer in the aforementioned
article quotes Homer Folks in a state-ment
that the families of this country
having illness in the course of a year
pay out in actual cash on account of
such illness the astounding total of
two billion dollars. The same total
amount is spent annually for public
education—from kindergarten to post
graduate universities. If cost in loss
of time and other economic loss is in-cluded,
sickness costs the American
people every year about fifteen billion
dollars. So, we see that in a way the
practice of medicine and the conduct
of hospitals for sick people constitute
about the biggest public enterprise in
the country. That being true it is in-evitable
that business and medicine
should form a new alliance, and the
foundation stone of the enterprise
must be preventive medicine. The pre-vention
of disease is a public enter-prise.
To achieve its finest results it
must be organized like an army, and
in the struggle for the ideal of longer
life and sounder health, the army must
be composed of individual physicians.
No faculty ever educated a student.
What the student gets is the sum total
of efforts made in his behalf by indi-vidual
instructors. No medical society
ever cured a patient. Some individual
member of the group must assume full
responsibility and do the job if the pa-tient
is to benefit. And that is what
Dr. Longworthy meant by calling the
physician a bedside engineer. If the
mass of the people are to receive the
benefits of this new alliance between
business and medicine they that are
well must be told how they may keep
well. That is an individual problem.
Each must read what some one per-son
writes for him or he must be told
by some individual. Who is better
qualified than the physician? If the
person who is sick is to benefit he
must have the attention of an individ-ual
physician. In the final analysis the
things that must be done to reach the
ideal may be summed up about as fol-lows:
1. Knowledge concerning the cause
of disease and the prevention of its
spread must be placed in the hands of
every intelligent individual. This is a
purely public health responsibility.
2. The services of a competent phy-sician
must be available for every sick
person regardless of where he lives or
how poor he is, for so long a period as
he needs such service. TTiis is ob-viously
impossible at present. So
the business part of this alliance be-tween
medicine and business must
see that:
January, 1930 The Health Bulletin 13
3. Hospital facilities are placed
within the reach of all. The physician
must practice more and more in con-nection
with hospital and medical cen-ters.
These hospitals must be placed
in the rural sections as well as larger
towns. Under this arrangement the
physicians will have available all mod-ern
methods of aid in diagnosis. Such
a system will result in
4. Better care for the patient at
much lower cost than at present. A
physician will be able to treat many
more patients, and to treat them
more competently. Having his office
and home in such a center, even
though it be in a small town, the of-fice
or ambulatory patients may re-ceive
assurance of more satisfactory
care, and patients needing bed care
can receive it easily. The cost must
be many times less than at present,
and the physician must receive much
better compensation than he does
now. Business methods can assure all
this and the physician and patient will
both retain forever the fine individual
relationship that has obtained in the
past, surely to the vast benefit of the
patient.
DRIVING ON THE LEFT SIDE OF THE ROAD
Here we are again talking about
traffic on the highways. However, in
view of the fact that mortality due
directly and indirectly to automobile
accidents constitutes one of the major
causes of preventable deaths in this
State, we feel justified in continually
writing something in the Bulletin
about the matter. It has been neces-sary
in the progress of the science
of public health in driving away at
the preventable causes of death to
keep continually before the public
these particular causes and how a dif-ferent
public attitude might result in
preventing death from unnecessary
causes.
There are not many rules for safety
on the public highways, but the few
rules that there are constitute some
very important ones, the breach of
which causes many deaths and much
suffering among the people who are
the victims. With the thousands of
automobiles running along our main
public highways every day at high
speed, the least variation from the
known methods of safety may at any
time instantly result in death to one
or more persons.
It has been our observation in our
journeys to and fro around over the
highways that a frequent cause of
traffic trouble, accidents and death, is
the man who persists in driving along
on the left side of the road. There
seems to be a large percentage of
such pests exercising the privilege of
driving automobiles all the time. This
particular insect seems to delight in
getting on a crowded highway and
piddling along at a low rate of speed
on the extreme left-hand side of the
highways in the country, and in the
city or town he gets just as far over
the middle of the driveway to the left
as he can possibly get without having
a collision with cars coming from the
opposite direction. TTiey seem to think
that the roadway is better on that
side, or that the atmosphere is more
rarefied and purer, or they may do it
for just pure carelessness. The driver
who wishes to pass, even on an open
road, has to wear his horn out calling
attention to his desires before any
notice is taken. By the time he reluc-tantly
and slowly begins to turn in,
one or more cars heave in sight com-ing
from the opposite direction, which
makes it impossible to pass, often for
a mile or more.
The chief characteristic of the left
side of the road driver seems to be his
desire to drive along slowly. When
coming meeting such a driver the le-gitimate,
careful driver of an on-com-ing
car almost has his hair standing
on end before this pest seems to take
notice and grudgingly turns back to-
14 The Health Bulletin January, 1930
ward the right, perhaps getting out
of the line of traffic just about the
time the driver meeting him has to
slam on his brakes or leave the road-way
entirely to avoid hitting him. Such
a habit is dangerous for several rea-sons.
One of the chief dangers, of
course, is the impossibility of drivers
of cars behind him being able to see
an on-coming car, perhaps just be-fore
a road intersection, or, in their
efforts to pass him, the on-coming
car is obstructed from view, and ac-cidents
often result. Another thing,
it is bad for the nervous system and
therefore the safety of every driver
of a car, and to the people he meets,
to have his calmness or his equanimity
upset from any cause. Such driving
frequently results in fatal accidents
to pedestrians also.
After all, the question of driving
comes back to the very old one of good
manners. A polite, considerate, well-bred
driver of an automobile will think
of the convenience and safety of the
drivers of other cars, as well as his
own, and will therefore govern himself
accordingly.
We would suggest to all persons
reading these lines, who are accus-tomed
to driving an automobile that
they ask themselves the question: "Am
I a left-hand side of the road driver ?
"
If the answer is in the affirmative,
our advice and request is to quit it.
BROKEN WINGS
By
SuDiE E. Pyatt
Paul was falling from a couple of
thousand feet above the earth. His
plane had gone bad, the left wing was
broken. He was crashing toward the
earth at terrific speed with no time
to adjust his parachute.
Just before he reached the earth
that rose to meet his broke plane,
he awoke swearing.
"D—n!" He could hardly breathe.
That left lung, the one the doctor had
pumped gas into that day was pain-ing
him as if a sharp knife had been
driven through it. Pleurisy, and the
spot still sore from the passage of the
needle that had introduced the first
shot of air into the pleural space be-tween
his lungs and his ribs, caused
the pain. No wonder he had dreamed
he was crashing to earth with a
broken airplane xwing.
Bird with a broken wing he was,
and birds with broken wings never
could soar so high again.
Paul groaned. The night nurse, a
silent figure in white, a lantern bob-bing
by her side like a huge firefly,
laid her hand gently on his arm.
"What is the trouble, Mr. Dun-bar?"
"D d bird with a broken wing!"
Paul sighed half asleep, but not for-getful
of the pain in his left side
—
—broken wing. "Never fly again.
No more stories from the pilot's seat
of my plane—broken wings—
"
Paul's voice trailed off into silence
under the nurse's ministrations. When
she left him he was sleeping again,
peacefully this time.
Feature writer for one of his state's
best daily newspapers, and airplane
pilot good enough to have a transport
license, Paul Dunbar had been sent
three months before by physicians who
would hear of no other course to the
State Sanatorium suffering from a
moderately advanced tuberculosis le-sion
in his left lung.
Paul should have responded to twen-ty-
four hours a day rest in bed in a
number of weeks, but he did not. The
January, 1930 The Health Bulletin 15
lesion began to look as if it might be-come
worse, and the physicians in the
institution decided to administer pneu-mothorax.
Far from being a model patient
Paul had objected at first, but had
finally acquiesced. He had received
his first treatment the day before the
night he had had his dream of dash-ing
from a great heighth in an air-plane
with a broken left wing.
Eighteen months of the sanatorium
and Paul was in the superintendent's
office receiving his final examination
and instructions before leaving the in-stitution
to resume his life back in
the world of men and women outside
the san's wall.
Paul was now what the doctors call-ed
a quiescent case of tuberculosis. He
would have to have the pneumothorax
treatments continued, and he could
work only a few hours a day. He sup-posed
he should feel thankful that the
"bugs" had not gotten him, but in
Paul's breast there was a dull, glow-ering
resentment.—"The bird with the
broken wing never soars so high
again."
—And sitting in the superintend-ent's
office listening to his final words
of instruction, Paul was dully aware
that back in the world again he would
be a bird with a broken wing, who
would never be able to soar so high
again. For the doctor said emphatical-ly:
"No flying for two years."
It had been nearly two years now
since he had flown, strong and well
up there against the sun. Two more
years, four years before he could fly
again! Was it worth it?
As Paul watched an army plane
skimming over the hazy blue hills
that surrounded the sanatorium he
felt for a moment that he had fought
in vain.
But the doctor had said he might
return to his work on the desk for
part time. Part time on the desk, he
who had been his paper's star report-er,
free to go in his plane to the ends
of the earth if he could find there a
story for his paper, was to be a desk
man, writing news that other report-ers
gathered, and handling copy that
the fellows who could get out on the
streets were too busy to write. Not
yet twenty-five, he had run his gamut,
was played out before his time, and
all because of that bad lung—d—
n
broken wing!
The fellows on The Ashton News
were nice to Paul. Nice because they
were sorry for him, he thought, as
deaf old Henry Clinard carefully
wrote down for him the information
about that Draketown Street robbery
the reporter had brought in before he
arrived, to make sure that he would
understand everything connected with
it.
Watching "Old Henry" Paul won-dered
how it would feel to never be
able to hear a sound.
"Not so bad," Henry had once vol-unteered
the information, "if you
don't get cross with people who holler
at you. Deaf folks don't like to be
On the Stump in Guilford.
16 The Health Bulletin January, 1930
bawled at any more than folks who
can hear do."
After that Paul was always very
careful to write out his communica-tions
with Henry, or to talk in a tone
of voice that would make the old
copy-reader feel that he was not bawl-ing
him out. Henry appreciated Paul's
thoughtfulness, and there were many
times when Paul's work would not
have been completed in the few short
hours he was on the desk if it had not
been for Henry's aid.
Gradually there grew up between
the deaf copy reader and the young
re-write man with the broken wing the
close bond of sympathy that always
unites the incapacitated regardless of
what the nature of the trouble is.
The first day Paul was back at his
old position he noticed a flower and
gift shop that had been opened up in
his absence in the little niche next
door to the newspaper office. It was
spring, early spring, and the first
yellow jonquils were blooming. The
little shop was filled with the bright,
sunny beauty of the yellow flowers,
and just behind them stood a girl,
whose hair was as sunnily golden as
were the delicate petals of the jon-quils,
and the smile she gave Paul
from dewy blue eyes, Paul was willing
to swear, was made of pure gold it-self.
"How much are they?" Paul found
himself vaguely indicating the whole
gorgeous display.
Again Jonquil smiled, for Jonquil
her name must be, she was so much
like the flowers.
"Twenty-five cents a dozen, or three
dozen for fifty cents," and she had not
finished speaking before Paul decided
that her voice was as flowerlike as her
face and her smile.
"O, give me all of them," he said
carelessly.
"All of them?" A puzzled frown
crossed the sweet, little face, some-thing
like a brisk wind blowing across
a bed of flowers.
"All of them!" Paul repeated em-phatically
after her.
"That will be $10, sir."
And Paul thought that her talking
of prices was as if one of her yellow
flowers had stepped out of its vase to
do business.
"Where shall I send them, or will
you take them?"
Paul looked puzzled for a moment.
The jonquils would overflow his one
room, bath and sleeping porch. "Send
them out to the Bausman County Tu-berculosis
Sanatorium," he said quick-ly.
"To anyone in particular?"
"No, to all of the patients."
"What shall I put on the card?"
"From a 'Broken Wing,' only." Paul
did not realize that his voice was bit-ter.
The girl smiled in quick sympathy,
and for a moment Paul's black mood
lifted.
"Say, isn't your name Jonquil?" he
asked impulsively.
"No, it isn't, I'm sorry, but—" she
stopped.
"I'm going to call you Jonquil."
"When?"
"Now, and every time I see you
—
you see,—" Paul suddenly found he
was floundering helplessly. "I work
next door on the newspaper."
"O, you're a reporter?"
"Yeah, sort of."
And with that Paul tipped his hat
and went into the office. He had found
suddenly that he would not like for
this golden, blue-eyed Jonquil to
think of him as a man with a broken
wing.
Paul had been back on the desk at
The Ashton News for three months
when Lon Dale, the greatest airplane
stunt flyer in the United States came
to Ashton. Paul had flown with Dale
in the days before he had known that
he had lungs.
The stunt flyer's air antics and the
reporter's ability at description had
given The News many good stories.
Dale and Paul, who were very fond
January, 1930 The Health Bulletin 17
of each other, were delighted to meet
again. It had been two and one-half
years since they had pulled one of the
hair raising airplane stunts. They had
not been together fifteen minutes be-fore
they were planning one of those
thrilling flights of the old days, Paul
forgetting once again that he had
lungs—that he was a bird with a
broken wing.
They buttonholed Bill Lacates, the
managing editor, as he came in. It did
not take them long to tell him what
they wanted. A story in The News that
Dale was back, and that he and the
reporter were going to give again some
of the stunts that had given Ashton
citizens such a thrill three years be-fore.
Bill listened, chewing the end of a
villainous black cigar.
"Sounds fine, Dale," he disregarded
Paul, "if you can get someone to go
up with you to cover the flights, as
Paul used to. Paul's not well, you
know. It would never do for him to at-tempt
it."
Dale's face fell, and Paul grew
pale, his eyes blazed. "Bill, you have
no right to say I'm not well enough
to get that story, any d—n story I
want to."
"Remember, Paul, you're a desk
man now, and I'm the only one who
can tell you to go outside, and I'm not
going to tell you."
With that Lacates walked into his
office, and Paul was left facing Dale,
white and shaken.
"I'm just a bird with a broken wing.
Dale. I can't even fly now by my doc-tor's
orders. For a minute I forgot.
Bill is right. That was his way of tell-ing
me, 'I'm no good'."
"Sorry, old boy," Dale rose and
shook Paul's hand. "I was looking for-ward
to some of our old stunts, but we
won't now."
Paul sat at the re-write desk,
smouldering resentment in his eyes
when Dale had gone. The managing
editor had really been kind not to let
him attempt the dangerous physical
strain the gathering of the material
for the air stories would entail, but
Paul did not want kindness, sympathy.
He wanted his old red-blooded strength
back. He didn't want to be a bird with
a broken wing.
It was the night of the afternoon
that Paul's managing editor had re-fused
to let him take the air assign-ments
that Paul learned that Jonquil
was crippled, and that her beautiful,
white-haired mother was blind.
He left the newspaper office, walk-ing
by the little flower shop with
dragging footsteps.
"Hello!" It was Jonquil, whose real
name was Marta Sennett, the flower
shop girl.
Since the day in early spring when
Paul had bought her total available
supply of jonquils all at one time,
the girl had not forgotten Paul, nor
had Paul forgotten her.
To speak to her every day, and to
stop in the shop a few moments to
talk to her was almost a ritual with
Paul—and with Jonquil, too, if he had
known.
Further than the greetings and
flower shop conversations the affair
had never progressed. Whenever Paul
thought of knowing her more inti-mately
he immediately became hot,
then cold.
A fellow with a broken wing had no
business being more than the most
casual of friends to a girl like Jon-quil.
But tonight things were different.
Jonquil had invited him around to her
home, because she told him her moth-er
was celebrating her fiftieth birth-day,
and she had been looking for him
all day to invite him to the party.
Mrs. Sennett was seated by a win-dow
that looked down on the street
when Paul let himself into the little
apartment in response to her invita-tion
to come in when he had knocked.
She called cheerily to him to come
across the room to her chair, telling
him that she knew who he was.
When Paul took the soft hand of
18 The Health Bulletin January, 1930
Jonquil's mother, and looked into the
eager face raised to meet his, he real-ized
with a start that she was blind.
Reverently Paul took the white
hand, and bending touched it with his
lips. He wondered why Jonquil had
not told him before that her mother
was blind.
Paul's surprises were not at an end.
As Jonquil came from the kitchen of
the little apartment, stripping off her
work apron as she walked, he saw
that she was crippled. Her left foot
and leg to the knee was horribly de-formed.
Looking at her Paul thought that
he had never before seen Jonquil out
from behind her flower counter. Crip-pled
herself, her mother blind, she
supported them both with the little
flower shop. Brave, gallant girl! No
wonder he had thought she was like a
flower when he had first seen her. A
wave of tenderness swept over him. He
wanted to go to her, to lift her in his
arms, and carry her so she would nev-er
have to use the hurt limb again.
TTien his high mood fell. Bird with
a broken wing, he was not even able
to lift her slender body once, much
the less care for her all of his life
as he wanted to.
Paul touched Jonquil's slim, little
hand softly. The blue eyes on his were
questioning.
"It has always been that way," she
said in simple explanation, looking
down at the deformed foot. "You do
not mind that I did not tell you." She
indicated her leg and foot, her moth-er's
sightless eyes. "Mother and I don't
like to talk about it. We play all of
the time that we are both well and
normal, and it makes everything much
happier for us."
Paul suddenly knew that her warm
little hand was still in his. He pressed
it quick and hard. "You wonderful
girl. Jonquil."
Paul was happy, happier than he
had been in a long time when he left
Jonquil and her mother that night.
Though happier he left railing mental-ly
against fate, life, whatever force it
is, that sends young men out to fight
life with broken wings, cripples beau-tiful
young girls, makes blind lovely
old women, and deaf good fellows like
Henry Clinard.
Passing by Dr. Herndon Benson's
home, Paul saw a light burning in the
doctor's office at the side of the
house. Doc had been a good friend to
him all along, even when he had in-sisted
on his going down to the san-atorium.
He would stop in and talk
to the doctor, see if the physician's
training, and the hard philosophy of a
medical man could help him to solve
some of his problems.
It was late, but Dr. Benson received
Paul with a smile.
"My, you're looking fine, young fel-low.
Weigh more than you did before
going to the San, don't you? Not so
bad this business of having one lung
after all, is it?"
Paul frowned. "Mighty tough, doc-tor,
when you want to do something
so bad you can taste it, and people
tell you that you can't because of your
lungs."
The doctor looked thoughtfully
down at a test tube in his hand. "Paul,
to some degree almost every man, wo-man
and child living is physically in-capacitated.
It may be only a very,
very slight trouble, but the physical-ly
perfect man or woman hardly ex-ists
at all, any doctor will tell you."
"Guess that's true, doctor, but they
don't have to go dragging around crip-pled
wings like my lung, have deaf
ears, sightless eyes and deformed
limbs," Paul spoke bitterly.
Dr. Benson carefully laid down the
test tube. "You are right at that, Paul,
but did you ever think of the large
number of people who fight organic
troubles? I myself have a bad heart. It
has been bad since my high school
days. My wife suffers from high blood
pressure, and has to stay away from
many social functions she would like
to attend. My oldest son can't play
high school football because of
January, 1930 The Health Bulletin 19
chronic bronchitis. Loretha, my daugh-er,
is underweight and everyday of
her life the food she has to eat is a
trial to her."
"I know, doctor, but those are all
disorders than can be cured."
The doctor shook his head. "Some-times
they can, sometimes not. We all
have our lives to live, Paul, making
them as worthwhile as possible, re-gardless
of whether all of our phy-sical
organs are in perfect order or
not. Perhaps some day we will breed
a perfect race, a race that will not
have to be bound down to earth by the
needs and the disabilities of our phy-sical
bodies today. That time has not
come yet, and those of us who are liv-ing
now have to give our bodies the
best care possible, paying particular
attention to the weakest members.
Then forget we have a body at all,
and live our lives in spite of physical
disabilities."
Paul got slowly to his feet. "There's
a lot in what you say, doctor. I haven't
seen daylight yet, but I'm going to
think things through. I hope 111 be
able to see as clearly as you do, when
I have thought them through."
"You will, Paul," the doctor laid
his hand fondly on the erect shoulders
of the tall young man. "Best of luck!"
As Paul walked homeward through
the night the physician thought what
a lucky chap Paul Dunbar was. Twen-ty-
five years ago his disease rapidly
advancing he would have probably
died. Now, modern medical science had
saved him, as firte a looking specimen
of young manhood as could be seen on
the streets.
The broken wing, Paul so bitterly
complained of, the doctor felt sure
Paul would find less of a disability as
time went on. He would learn to live
his life despite the broken wing.
In the gray dawn of the morning
after Paul had been to Jonquil's moth-er's
birthday party, and talked to Dr.
Benson, he wrote the editorial "Brok-en
Wings" that won for him that
This distinguished Jackson county couple are 82 and 85 [icars <>/